Honey bee surveillance systems are increasingly used to characterize honey bee health and disease burdens of bees in different regions and/or over time. In addition to quantifying disease prevalence, surveillance systems can identify risk factors associated with colony morbidity and mortality. Surveillance systems are often observational, and prove particularly useful when searching for risk factors in real world complex systems. We review recent examples of surveillance systems with particular emphasis on how these efforts have helped increase our understanding of honey bee health.