Listeriosis, caused by Listeria monocytogenes, is a significant public-health concern as a result of its clinical severity and high mortality. Large foodborne outbreaks of listeriosis have occurred during the last two decades in Europe and the United States, but to date there have been no food-mediated epidemics of the disease and very little information is available on the number of cases of listeriosis in Japan. We performed a nationwide surveillance study of listeriosis. The data were collected between 1980 and 2002, and 95 case reports were identified from 1996 to 2002. We divided 13·6 (cases per year between 1996 and 2002) by the ratio of the number of beds in hospitals that replied to the questionnaire, to that of all the hospitals in Japan and estimated that there is an average of 83 cases of listeriosis per year and an incidence of 0·65 cases per million of the population in Japan.