Within the ongoing strategy of the Workers' Health program at the Pan American Health Organization on strengthening surveillance in the field of workers' health in the Americas (the Region), a project was conducted in July 1999 in Washington, D.C. The objectives of the project were to discuss the problems found in the surveillance of workers' health, to develop a methodology and use it to prioritize and select the top three occupational sentinel health events for incorporation into the surveillance systems in the Region, and to develop the initial protocols for establishing the surveillance systems for the three chosen occupational sentinel health events. The Pan American Health Organization invited 24 occupational health experts from the Region to participate in the project. Over an intensive 3-day period, the experts heard reports of workplace surveillance activities in the various countries in the Region; developed prioritization methods; identified and prioritized a list of occupational sentinel health events; and developed three surveillance protocols, one each for occupational fatal injuries, pesticide poisoning, and low back pain. The results on the prioritization of occupational sentinel health events and the development of surveillance protocols are reported in this article.