After the World War II, poison centres (PC) were created with the goal of improving the care of poisoned patients and prevention. Four decades later, they are still recognised for their traditional activities, but they are faced to new challenges. The development of numerous toxicological databases on CDROM or on the Internet has changed the needs of health professionals to call a PC, reducing the number of enquiries but increasing the need of expertise. The general concern about the cost-effective utilisation of the scarce health care resources will enhance the role of PCs in the reduction of unnecessary referral to emergency departments. Health authorities require the implementation of continuous surveillance system of chemical-related events and a real-time alerting procedure concerning terrorism attacks, child health and other serious events. But, to be able to achieve these new roles, PCs need to change the way they collect, validate, and analyse the information from cases and they must develop real-time capacity of detecting an unusual event. It has been recognised that PCs were in a unique position to monitor patterns, incidence and severity of exposures and to detect new trends. They could contribute to the accuracy of risk assessment documentation and help to identify the priority list of chemicals that need to be assessed or reassessed. But, in the perspective of using PCs' data for global risk assessment and public health, the main challenge is the development of international harmonization of human poisoning data collection to allow their comparability. In the future, PCs will continue to have a leading role to play in the health protection of the population. Therefore, of particular importance is their mobilisation to stabilise the traditional activities, to initiate new activities, to acquire new skills in toxicology, methodology and quality assurance, to recruit and to train new staff and to find adequate funding to sustain and expand their operations.