Mass gatherings may be associated with particular health hazards including injuries, sun burns and thermal shocks and also infectious diseases. For that reason preparations for mass gatherings should include easy access to health facilities and enhanced epidemiological surveillance. Potential threat of bioterrorist attack should always be considered at mass gatherings. In the preparation of the enhanced surveillance system increased cost of implementation and operation should always be considered. System based on functioning routine surveillance require less investment then newly implemented ones. New systems require also more training and usually more operational effort from the personnel who encounters it for the first time. Syndromic systems are noted for high sensitivity, but they require cooperation with laboratories for confirmation of diagnoses. Of particular importance for effectively functioning enhanced surveillance is proper training of personnel which will operate it. Training should be tailored to the character and size of the gathering as well as to the structure of the implemented system. Besides technical training it should include also motivational aspect.