The use of extensive monitoring approaches in patients with various forms of hypoxic disease has flourished extensively during the past decade. When coupled to advanced computer technology, the capacity for generation and storage of data has increased enormously. In addition to clinicians and biomedical scientists, the field has attracted engineers and computer scientists. Most of these developments have occurred without adequate evaluation of the impact of these efforts on the safety and effectiveness of patient management. Moreover this expansion has occurred without a predesigned structural format for either evaluation or for quality control of the various monitoring modalities. Two basic assumptions are widely accepted: 1) That massive data collection is automatically useful; and 2) Monitoring coupled to computerization necessarily leads to better outcome for patients. This paper will challenge both of these assumptions by providing an analysis of monitoring generally with special emphasis on hypoxia. In addition it will describe some current developments in the monitoring of hypoxia.