Public health surveillance systems in South Africa aim to monitor and control infectious diseases effectively. However, their methodological robustness and cost-effectiveness have not been systematically evaluated. A comprehensive search strategy was employed to identify relevant studies, which were then assessed using predefined inclusion criteria. The study focused on evaluating the methodological quality and cost-effectiveness of these surveillance systems through a meta-analysis approach. The analysis revealed that while some surveillance systems in South Africa showed promising results, there was significant variability across different regions in terms of case detection rates and operational costs. This review highlights the need for standardised methodologies to enhance the reliability and cost-effectiveness of public health surveillance systems in South Africa. Standardised protocols should be developed and implemented, ensuring consistency in data collection methods and enhancing the comparability of results across different regions. Public Health Surveillance, Quasi-Experimental Design, Cost-Effectiveness, South Africa Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.