Surveillance is the systematic collection, analysis, utilization, and sharing of health data with stakeholders in order to support public health programming. Surveillance for heat-related disease and death supports the efficiency and effectiveness of public health interventions to reduce risk. Common early indicators include emergency medical service calls, emergency department utilization, and hospitalization; mortality is a lagging indicator. Information on hazard exposure and population vulnerability are important additional data streams. Surveillance for heat-health impacts can be incorporated into existing surveillance platforms; implementation typically takes several years. While there are no cost-effectiveness estimates for heat surveillance, specifically, surveillance activities are highly cost effective, particularly for commonly encountered hazards with high mortality risk in large populations.