Shiga toxin-producing E. coli (STEC) pose a major food safety problem in industrialized countries and have caused several large-scale outbreaks with high fatality rates. In France, a surveillance system for pediatric HUS was established in 1996. It is coordinated by the French Institute for Public Health Surveillance and was implemented following a study that included a retrospective survey of cases hospitalized between January 1993 and March 31, 1995. The objectives of this surveillance are to track the spatial and temporal trends of HUS in children under 15 years of age in France, to identify the characteristics of cases, to determine the causative agents, and to detect epidemic outbreaks.