Public health surveillance is essential to protect the health of the population and address health inequities. The World Health Organization (WHO) Guidelines on Ethical Issues in Public Health Surveillance is a comprehensive international ethical framework that provides specific guidance on surveillance work and its challenges. This article illustrates this publication’s relevance in guiding surveillance in four areas prioritized by the Pan American Health Organization: 1) monitoring health inequalities and their determinants; 2) controlling noncommunicable diseases and their risk factors; 3) eliminating communicable diseases; and 4) preparing for and responding to public health emergencies. While advances have been made in the integration of ethics into public health surveillance, this article presents several challenges that urgently need to be addressed in the Region of the Americas.