A surveillance system for rubella infections in pregnant women and congenital rubella was established in France in 1976 through the Rénarub laboratory network. Its purpose is to assess the impact of the rubella vaccination policy and progress toward the elimination of congenital rubella. Laboratory technicians report cases of maternal rubella infection with positive IgM or confirmed diagnoses of infection in newborns or fetuses to the French Institute for Public Health Surveillance. Clinicians are then asked to complete a questionnaire with demographic, laboratory, and clinical information on the infected pregnant woman, the fetus, or the newborn. The number of reported maternal rubella infections was 10 in 2004 and 16 in 2005, corresponding to incidence rates of 1.3 and 2.1 cases per 10,000 live births (LB). These 26 infections resulted in the birth of 4 children with congenital rubella syndrome (CRS) and 5 pregnancy terminations. The highest rates of maternal infections are observed among women aged 15 to 19. Although the annual incidence rate of CRS has been below 0.5 cases per 10,000 LB in France since 2002, the occurrence of 10 to 20 maternal infections each year indicates residual circulation of the virus, particularly among young adults. Efforts must continue to increase vaccination coverage among children and to strengthen catch-up vaccination among non-immune adolescents and young women. (R.A.)