The burden of chronic diseases is increasing worldwide. Surveillance of behavioral risk factors is a crucial element for prevention and control of chronic diseases. Adequate surveillance data will provide the basis for developing and implementing appropriate preventive programs at the local and country level. A standardized surveillance system worldwide will allow data comparability, and will decrease the cost of the surveillance system. By using lessons from the Behavioral Risk Factor Surveillance System, a large, ongoing, state-based surveillance system in the United States, countries may save limited resources, and expedite the initiation of their own surveillance systems. To prevent cardiovascular diseases worldwide, it is time to develop and implement appropriate surveillance systems at a country level, in order to track risk factors. This strategy will provide the basis for developing intervention programs designed to reduce, or prevent a further increase in, the burden of chronic diseases.