Although public debate in Canada about climate change and air pollution is louder than ever, the state of the environment remains a relatively neglected determinant of health, and environmental public health infrastructure and programs are poorly developed. Health Canada has only recently begun to develop a national environmental public health tracking or surveillance system. The authors review progress on environmental public health tracking in other jurisdictions and suggest a strategic approach to the development of a coherent national system of sensitive, targeted surveillance indicators for environmental health by addressing the following questions: Which environmental hazards and exposures, and which health effects along the continuum from “release” to “health effect,” should be tracked? Which indicators are scientifically robust and practical for tracking environmental health problems in Canada?