Because the feasibility and usefulness of routine surveillance for infections in nursing homes has been questioned, we reviewed the elements of infection surveillance programs developed by two nursing homes using existing personnel. Although infection definitions and data collection methods differed between the two homes, both homes identified urinary and respiratory tract infections as the major endemic problems at their institutions and demonstrated important clusters of gastrointestinal tract and eye infections. Surveillance data were used to identify individual patients who required follow-up by physicians, to justify special infection control measures for clusters of gastrointestinal tract and eye infections, and to provide the basis for in-service education in infection control. Routine surveillance for infections is both feasible and an integral and valuable part of overall infection control programs at two large Maryland nursing homes.