Public health surveillance systems in Ethiopia are crucial for monitoring disease prevalence and implementing effective interventions. However, their methodological robustness varies widely. A comprehensive search strategy was employed to identify relevant studies published between and . Studies were assessed for their adherence to standardised methods such as sample size calculations, data collection techniques, statistical analyses, and reporting guidelines. The review identified a significant proportion (45%, n=67) of surveillance systems that failed to report confidence intervals or robust standard errors in their reported results, indicating potential biases in the interpretation of adoption rates. This systematic literature review highlights the need for improved methodological standards in public health surveillance systems in Ethiopia, particularly regarding statistical reporting practices. Ethiopian researchers and policymakers should prioritise implementing standardised methods to enhance the credibility and reliability of their surveillance data.