Abstract: Clostridioides difficile is a gram-positive, spore-forming, anaerobic bacterium. C. difficile infection shows a wide spectrum of clinical manifestations, including mild diarrhea and life-threatening conditions such as pseudomembranous colitis and toxic megacolon. In recent years C. difficile infection has become a major global public health concern in the context of wide use of antibiotics and population ageing, causing substantial economic burden and health loss. However, China currently lacks a well-established national surveillance system for C. difficile infection, resulting in insufficient estimation of its true disease burden. To address this gap, this paper systematically summarizes the current status of C. difficile infection surveillance systems in major countries, compares and analyzes similarities and differences of different systems in data collection, diagnostic criteria, case classification, and technology application, analyzes the strengths and limitations of current surveillance system, and makes suggestion for its future development to provide reference for the establishment of a scientific and effective C. difficile infection surveillance system in China.