Public health surveillance (PHS) is an essential public health activity, which entails collecting data on diseases and disease-related states in a timely manner to aid in international health regulations and in local health planning. Opinions differ sharply on whether it is a research or non-research activity. In recent years, most low- and middle-income countries (LMICs) have been establishing their own PHS systems, with or without support from external donors, to comply with the stipulations of international health regulations. With the expansion of the scope and role of PHS in ensuring the health security of countries, it is important to understand the ethical principles of PHS and the specific ethical issues involved in it, as well as the need for ethical oversight of PHS. This paper deals with these aspects of PHS, and highlights the need for specific ethical guidance and oversight mechanisms in LMICs that are setting up their own PHS systems.