This paper reviews surveillance approaches for occupational injuries and evaluates three emerging methodologies for the enhancement of work-related injury surveillance: (1) narrative data analysis, (2) data set linkage, and (3) comprehensive company-wide surveillance systems. All three methods are the result of new applications of computer hardware and software that have apparent strengths and limitations. A major strength is the improved description of work exposures and related injuries leading to better understanding of injury etiology. This understanding, however, is limited by the data quality and completeness entered on records at the time of the injury. We recommend (1) more widespread inclusion of narrative text in databases, analyses of which can be a valuable supplement to injury coded data; (2) the increased use of data set linkage studies to combine injury and work-history data; and (3) the development of comprehensive company-wide surveillance systems to expedite the use of epidemiologic data for occupational injury prevention activities. Further development of these methods and others is encouraged, especially in light of technological advancements in data capture, analysis and presentation. Only through such efforts can we best apply epidemiologic principles to preventing injuries in the workplace.