After the first successes of ART, this technique showed a rapid development, in many countries. It soon appeared to the professionals themselves that a number of important health concerns were related to the new technique, in terms of practice, efficacy and safety. Moreover, the competition between centers requested solid data for the public and health authorities correct knowledge, based on large samples. This resulted in the development of national, regional, and world registries. It needed general agreements on definitions, numerators, denominators, ways of reporting, that were obtained through several workshops that included WHO. This chapter outlines, in a first section, general importance of surveillance, on efficacy, and safety (immediate and long term, women and children). The second section describes the history itself, from national to regional and world (ICMART) registries. It shows that a lot has already been done, even if efforts are still needed to improve quality, but it is better to have insufficient knowledge than none at all.