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Public health surveillance systems are critical for detecting and responding to health threats. This review aims to analyze international literature on the performance of these systems in terms of core, support, and attributes of surveillance system. Systematic review. Following the preregistered protocol (PROSPERO: CRD42022366051), a systematic search was conducted on PubMed/MEDLINE, CINHAL, CABI, Web of Science, and Google Scholar for articles evaluating Public Health Surveillance System performance from inception to July 21, 2023. Various study designs were included, and quality assessment was performed. Thematic analysis categorized findings into key surveillance system functions. Nine studies from different countries assessed core and supportive functions, as well as surveillance attributes. Performance varied among countries, with some excelling overall and others showing poor performance in specific areas. Many countries' surveillance systems had inadequate performance in key measures in terms of the core and supportive functions, as well as the attributes of the surveillance system. This review shows significant variations in the performance of public health surveillance systems across countries. Further research is needed to understand underperformance reasons and inform global policymaking for strengthening surveillance systems. [ABSTRACT FROM AUTHOR]