The Agency for Toxic Substances and Disease Registry (ATSDR) has specific interest in surveillance methods as part of its studies of health effects potentially associated with environmental contamination sites (1,2). An earlier ATSDR-sponsored conference, held 30 October-1 November 1989 in Asheville, North Carolina, laid much of the groundwork for considering a specific listing of health events as candidates for this sentinel application (3). This report is the product of a sequel conference charged to review the available scientific literature, assimilate relevant experiences, and produce a framework for a listing of sentinel health events (SHEs) for use in monitoring health around sites of environmental contamination. This consensus panel was convened 18-19 May 1992 at the University of North Carolina, Chapel Hill, to identify SHEs that could serve as indicators of environmental contamination. Early in the conference there were several presentations building upon Rutstein's original supposition regarding SHEs (4). Recent other works relating to the use of sentinel events in public health surveillance were also discussed (5-9). Two days of deliberations followed. Presented here are the consensus statements and recommendations that resulted from this endeavor.