There is a rise of non-communicable diseases (NCDs) burden, which is causing increasing morbidity and premature mortality in developing countries. In 1990, cardiovascular diseases (CVD) accounted for 63 per cent of all deaths and India contributed to 17 per cent to the worldwide mortality. Several surveys conducted across the country over the past two decades have shown a rising prevalence of major risk factors for CVD in urban and rural populations. These surveys are limited by their generalisability to other parts of the country, and more was required to roll out of an action plan. There was lack of an organized national system for monitoring these risk factors over time so as to inform policy and programme for appropriate interventions. The Indian Council of Medical Research (ICMR) leveraged its research on NCD risk factor surveillance to the development of the national plan under the Integrated Disease Surveillance Project (IDSP) which will obtain State-based prevalence of selected risk factors. This review provides the scenario of CVD in India and the need for a surveillance system. By examining similar experiences globally, it outlines the scope of CVD surveillance in India.