Background:The 2014 Ebola crisis in West Africa has highlighted the importance of an effective notifiable disease surveillance system (NDSS) at country level. This study was conducted to determine the perceptions of key stakeholders on the NDSS attributes of usefulness, timeliness, simplicity, flexibility and acceptability in South Africa.Methods & Materials: During 2015, a nationally representative cross-sectional survey of communicable diseases coordinators and surveillance officers at national, provincial and district health levels, as well as members of the National Surveillance Forum, the South African Malaria Elimination Committee and the National and Provincial Outbreak Response Teams was conducted. Individuals with less than one year experience of the NDSS were excluded from the study. Participants completed a self-administered questionnaire after giving informed consent. In addition to demographic information, the questionnaire elicited information on participants' perceptions of the NDSS attributes. The survey was analyzed using STATA ® version 14.Results: The majority of survey participants (n = 114) were from the National Outbreak Response Team, with a median of 10 years' experience with the NDSS. On the criterion of acceptability, which measures the willingness of providers to participate in the system, a mean score of 47% was obtained. Similar low mean scores were obtained on timeliness (55%), which measures the promptness of taking appropriate action; on flexibility (55%), which measures the adaptability of the system; usefulness (61%) and simplicity, on which a mean score of 66% was obtained.In the multiple logistic regression analysis, factors associated with positive perceptions on the effectiveness of the NDSS were participation in Provincial Outbreak Response Teams (Coef-ficient=10.41, p-value 0.005), participation in disease detection (Coefficient =-15.24, p-value 0.020), and participation in disease control and response (Coefficient =-16.41, p-value 0.011).Conclusion: The overall low percentage scores on the system attributes indicate that stakeholders do not regard the South African NDSS as acceptable, flexible, simple, timely and useful. The study findings should inform the revitalisation of the NDSS in South Africa and enhancing the participation of NDSS stakeholders.