Since 2020, the surveillance of surgical site infections (SSIs) has been part of the Surveillance and Prevention Program for Infection Risk in Surgery and Interventional Medicine (Spicmi). This program is led by the Île-de-France Center for the Prevention of Healthcare-Associated Infections (CPias) as part of the national priority initiatives on healthcare-associated infections (HAIs) coordinated and defined by Santé publique France. Under the Spicmi protocol, two levels of surveillance have been offered to healthcare facilities: surveillance without collection of risk factors (“unit-based”) and surveillance with collection of risk factors (“patient-based”). The results of both surveillance efforts are detailed in the report. Each year between January and June, data regarding the index surgical stay, type of procedure, reoperations, and rehospitalizations are extracted from the Hospital Information System (HIS) for 18 target procedures. A semi-automated algorithm detects suspected SSI cases by cross-referencing various criteria. Validation of the SSI diagnosis is then performed by the surgeon and/or a physician from the Surgical Infection Control Team (EOH). All included patients must be followed up through the 30th postoperative day (90th postoperative day for cardiac, orthopedic, and breast implant surgery). SIS are defined according to standard criteria (CDC/NHSN, 2025). Patient-based surveillance allows for the collection, in addition to the data mentioned above, of SIS risk factors (age, ASA [American Society of Anesthesiologists] score, duration of surgery, Altemeier contamination class, emergency/elective surgery, use of video-endoscopy, presence of an implant/prosthesis, multiple procedures), and, if possible, comorbidity data (optional) for each patient. The incidence rates and incidence density of SSI are calculated based on these factors with their 95% confidence intervals [95% CI]. In 2024, 243 institutions participated in the Spicmi program, of which 47 opted for “patient-based” surveillance. The ISO rate, calculated at the national level across all specialties, was 1.34% [1.29–1.4]; 41% of these infections were deep-seated, and they affected an organ or body cavity in more than a quarter of cases (32.6%). Staphylococcus aureus was involved in nearly a quarter of cases (24.2% of SSI cases), and 10.8% of these cases involved methicillin-resistant S. aureus (MRSA). Among the types of surgical procedures with the highest SSI rates were: hip prosthesis revision (4.44% [3.58–5.29]), coronary artery bypass grafting (3.81% [2.92–4.7]), and prostatectomy (3.79% [2.88–4.7]). The results of the 2024 surveillance confirm the clinical and microbiological characteristics of SSI for the types of procedures studied. They are generally consistent with the literature, but the SSI rate is likely underestimated for gastrointestinal surgery. Improvements in semi-automated SSI detection and changes in the case mix may explain part of the increase in the SSI rate reported in certain specialties. Increasing participation in the Spicmi surveillance program, particularly in the “patient-based” mode, remains a major objective.