Web-based secure communication systems have revolutionized data collection systems in medical research. Such systems provide opportunities for a study with exceptionally large sample sizes and have the potential to provide timely information about current trends in disease incidence, treatment, and outcomes. Globally, National Audit of Myocardial Infarction Project (MINAP) (1), Prospective Registry Evaluating Outcomes after Myocardial Infarction: Events and Recovery Quality Improvement (PREMIER-QI) (2), Acute Myocardial Infarction in Switzerland (AMIS) (3), Internet Tracking Registry of Acute Coronary Syndrome (i*trACS) (4), etc., are a few of the cardiovascular disease (CVD) registries using internet for real time data collection. Despite India’s internationally renowned competence in information technology, there are no web-based disease registries for CVDs suggesting a need for undertaking pilot projects in this area, which if found successful, can be replicated throughout the country. Planning and evaluation of preventive strategies for acute coronary syndrome (ACS) requires disease surveillance with a broad concept of collecting data on risk factors, disease patterns, disability and health practices. Several population based cross-sectional studies in India have shown a rising trend in the prevalence of coronary artery disease (CAD) in urban India (5-12) (from 1% in 1960 to 10.5% in 1998) as well as in rural India (a two fold increase) (10, 13-14). It has been estimated that India had the highest number of deaths (over 1.5 million) in the word due to CAD in 2002 (15) which is expected to double from 1985 to 2015 (16,17). The INTERHEART study in 52 countries observed high prevalence of CAD risk factors like diabetes, hypertension, smoking, dyslipidaemia and obesity in Indian population (18). The prevention and treatment of CAD will require a highly responsive healthcare system. In India, though specialized healthcare centers do provide state of the art technologies for cardiovascular care, but the healthcare delivery varies from State to State as well as within the State. Not only the number of primary and community healthcare centers is inadequate, there is a shortage of physicians (particularly with specializations in cardiology) and other healthcare staff. In cardiac care, more than 75 per cent of the care is provided by private sectors, which are concentrated in urban areas (19). This highly inadequate preventive and therapeutic cardiac care, especially in rural/remote areas, poses a challenge for development of a sustainable cardiac disease surveillance system.