Epidemiological surveillance is fundamental to optimize disease prevention and control strategies in aquaculture. Therefore, a disease surveillance program was implemented in 2023 with the highest representativeness of the tilapia farming industry in the South, Southeast, Midwest, Center-West and Northeast region of Brazil. Fish were collected from different farming systems (hatchery/hatchery tank, net tanks, among others) and production stages (fry, juveniles and adults). The program was based on the identification of viruses and bacteria by real-time qPCR directly in tissue samples and bacteriological culture with MALDI-TOF identification. In addition, antibiogram and minimum inhibitory concentration (MIC) assays were performed for all bacterial isolates obtained. Of the total 10700 qPCR analyses performed in 2024, Streptococcus agalactiae was the most prevalent pathogen (16%), followed by ISKNV (15%) and Lactococcus sp. (13%). From bacteriological cultures, 2019 bacterial isolates were obtained and identified as S. agalactiae (36.3%), Lactococcus sp. (19.2%), A. hydrophila (14%), Edwardsiella tarda (10.1%), A. veronii (8%) and Francisella orientalis (3.9%). Among the positive cases for ISKNV recorded between Oct and Dec 2024, a high rate of coinfections with bacterial agents was observed . Lactococcus sp . was the most prevalent (51%), followed by Aeromonas veronii (28%), S. agalactiae (11%), E. tarda (4%), A. hydrophila (4%), and F. orientalis (2%). These findings underscore the complexity of the clinical scenario in field conditions , with seasonal variations influenced by environmental and management factors . This epidemiological surveillance program , unprecedented in Brazilian tilapia farming , has been essential in guiding control and prevention strategies across different production systems.