<p>Ethiopia started Human Immunodeficiency Virus (HIV) Case-Based Surveillance (CBS) system along with the Research Electronic Data Capture (REDCap) in June 2019. For the period January-June 2022, only five out of 14 CBS implementing health facilities in DireDawa reported 35 newly diagnosed HIV patients through the REDCap Database compared to 314 in the District Health Information System (DHIS-2). This study aimed to describe the case-based surveillance system attributes, usefulness, reasons for under-reporting and provide recommendations.Ethiopia started Human Immunodeficiency Virus (HIV) Case-Based Surveillance (CBS) system along with the Research Electronic Data Capture (REDCap) in June 2019. For the period January-June 2022, only five out of 14 CBS implementing health facilities in DireDawa reported 35 newly diagnosed HIV patients through the REDCap Database compared to 314 in the District Health Information System (DHIS-2). This study aimed to describe the case-based surveillance system attributes, usefulness, reasons for under-reporting and provide recommendations.</p>