A toxicovigilance system was established in Réunion during the 2006 chikungunya epidemic to monitor health effects associated with exposure to insecticides used for vector control. This system was expanded in late 2007 to include all pesticides and personal insect repellents. This surveillance was based on collecting reports from various sources, investigating these reports by a consulting toxicologist, and analyzing the data by the Indian Ocean Regional Unit of the French Institute for Public Health Surveillance, in order to synthesize the findings and provide feedback to partners. In 2008, the surveillance system collected 257 reports potentially linked to exposure to a pesticide or personal insect repellent. Among the 167 exposure cases identified after removing duplicates, 62 (37%) had symptoms consistent with exposure (possible cases). Sixteen cases (26%) resulted from accidental exposure, primarily through inhalation of pesticides during product application. The remaining 46 cases (74%) involved intentional exposure due to suicide attempts. It appears important to have local toxicological expertise in an overseas department located far from mainland France. Discussions are underway to expand the system to cover all cases of poisoning occurring in Réunion and Mayotte. (R.A.)