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Surveillance for Middle East Respiratory Syndrome (MERS) has been undertaken in the UK since September 2012. This study describes the surveillance outcomes in England from 2012 to 2018. This was a descriptive study using surveillance data. Local health protection teams in England report possible MERS cases to the National Infection Service with clinical and laboratory data. A total of 1301 possible MERS cases were identified in the study period. Five cases were laboratory-confirmed MERS. The majority of cases had travelled to Saudi Arabia (56.7%) and United Arab Emirates (25.9%). Fifty-four percent of cases were men and 43.7% were women. The majority of cases (65.1%) were aged 45 years or older. The number of tests increased in the period after Hajj each year. Laboratory-confirmed alternative diagnoses were available for 513 (39.4%) cases; influenza was the most common virus detected (n = 255, 52.4%). Our study highlights the importance of differential diagnosis of influenza and other respiratory pathogens and early influenza antiviral treatment. • Routine surveillance for Middle East Respiratory Syndrome has been carried out. • In total, 1301 possible cases were identified including five laboratory-confirmed cases. • Influenza was the most common pathogen detected for differential diagnosis. [ABSTRACT FROM AUTHOR]