About 1345 cases of suspected malaria were reported and 345(25.65%) of them were positive for plasmodium parasite. A standard case definition for the selected diseases was available at Tahtay koraro district health office and at all visited health centers. All respondents from all health facility agreed that a case definition is easy and applicable for malaria case detection, easy to integrate the system with other systems without much difficulty and from assessed health centers only 80% of the reporting formats were complete with necessary information. Most of health professionals and organizations accept and well engaged in the surveillance systems to strengthen the surveillance activities in the district. Timeliness of the assessed health centers was 65%, 45% and 30% for Beles health center, Semema health center and Beles health center respectively. The positive predictive value was 25.65%.