This article describes the procedures and quality of the tetanus surveillance system, as well as the incidence of tetanus cases in France in 1998 and 1999. Mandatory reporting makes it possible to track changes in tetanus incidence and to identify its main epidemiological characteristics. Thus, it allows for the evaluation of the impact of preventive measures, particularly the impact of tetanus vaccination. The incidence of cases occurring in 1998 and 1999, which were subject to mandatory reporting, was 0.34 and 0.29 per million inhabitants, respectively. It was 0.49 in 1997, 0.67 in 1996, 0.46 in 1995, 0.69 in 1994, and 0.88 in 1993. There has therefore been a decrease in the incidence of cases over the years despite the increase in the average age of the population. Although the annual number of tetanus cases remains low, this infection remains a serious disease leading to prolonged hospitalization in intensive care, which may be accompanied by sequelae and has a high case-fatality rate.