In the developed world, surveillance for AIDS has provided up-to-date information for researchers, clinicians, public health workers and policy makers. In Africa, however, there is no standardized format or methodology for AIDS surveillance. In August 1987, Uganda developed a clinical case definition for AIDS reporting, based upon the World Health Organization (WHO) clinical case definition for AIDS in Africa and began formal surveillance. Surveillance is passive and primarily hospital-based. At the end of July 1988, 5142 cases of AIDS had been reported to the Ministry of Health; 4583 (89%) had confirmatory HIV-antibody testing. Of the 4938 (96%) cases that had their sex recorded, 2358 (48%) were male and 2580 (52%) were female. The mean age of 28.4 years for male patients is higher than that of 24.4 years for female patients (P < 0.0001). Only 18 (< 1%) cases have been reported in children between 5 and 12 years of age. Case reports are returned via the District Medical Officers to the Ministry of Health where they are entered into a microcomputer from which a monthly report is generated for feedback to the reporting stations. Here we describe a simple national reporting system to follow the progression of the AIDS epidemic which could be established in Africa using limited resources.