A listing of state by state reporting requirements for occupational disease, as of September, 1988, was provided and discussed. The data were provided by each state and territorial epidemiologist, and discrepancies between prior and current reporting practices were clarified. Occupational infectious diseases were not included in the discussion. Case reporting was considered an essential disease surveillance activity which could influence the choice and implementation of control measures. Case reports, worksite inspection, systematic recording and analysis of reported data, and feedback of information on trends and control activities to reporting providers to increase their ability in occupational disease recognition were identified as components in an ideal surveillance system. The Sentinel Health Events (Occupational) listing was considered an important effort to improve disease recognition and the focus of surveillance activities. In the absence of quality provider reporting, laboratory reports, workers' compensation records, the NIOSH Sentinel Event Notification System for Occupational Risks and the Annual Survey published by the United States Bureau of Labor Statistics were considered to be useful methods of occupational disease case identification.