The use of Chinese medicinal materials (CMM) in the context of Traditional Chinese Medicine (TCM) is increasingly prevalent in Canada and worldwide. Self-medication with CMM and concurrent usage with Western medicine are also common. While taking CMM carries recognized risk of adverse effects on their own, their interactions with Western medicine can further generate additional adverse effects but are largely underestimated and undetected due to under-reporting. This is especially true in Canada and other Western countries where CMM is regulated as natural products. Currently worldwide, surveillance of CMM is variable and primarily through spontaneous and voluntary reporting systems. Current approaches in the Western world, including Canada, are by-and-large ineffective in detecting CMM-Western medicine adverse interactions. We propose the development of a Canadian surveillance system for CMM usage that involves both health professionals and patients so as to increase detection of potential adverse reactions and improve safety. As a first step, we will carry out surveys and focus groups with the stakeholder groups to identify desirable features of such a surveillance system as important ground work.