Objective Healthcare-associated infection (HAI) surveillance programs are critical for infection prevention. Australia does not have a comprehensive national HAI surveillance program. The purpose of this paper is to provide an overview of established international and Australian statewide HAI surveillance programs and recommend a pathway for the development of a national HAI surveillance program in Australia. Methods This study examined existing HAI surveillance programs through a literature review, a review of HAI surveillance program documentation, such as websites, surveillance manuals and data reports and direct contact with program representatives. Results Evidence from international programs demonstrates national HAI surveillance reduces the incidence of HAIs. However, the current status of HAI surveillance activity in Australian states is disparate, variation between programs is not well understood, and the quality of data currently used to compose national HAI rates is uncertain. Conclusions There is a need to develop a well-structured, evidence-based national HAI program in Australia to meet the increasing demand for validated reliable national HAI data. Such a program could be leveraged off the work of existing Australian and international programs. What is known about the topic? There is a large volume of literature demonstrating the effectiveness of national HAI surveillance programs in reducing the incidence of HAIs. Although some of the larger states of Australia have individual programs, a formalised national program does not exist. A well structured national HAI program in Australia would improve the understanding of the epidemiology of HAIs in Australia and provide high quality data for performance monitoring and ensuring that HAI prevention interventions are targeted appropriately. What does this paper add? This paper reviews well established international HAI surveillance programs and highlights the benefits and limitations of these programs, and identifies the gaps that currently exist in Australia. The paper then maps out a pathway towards the development of a national program. What are the implications for practitioners? This paper will act as a guide for future research and policy activities required for the establishment of a national HAI surveillance program in Australia.