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Sudan continues to face major public health challenges due to escalating violence, natural disasters, and recurrent outbreaks of neglected tropical diseases (NTDs). This study aimed to evaluate the NTD Surveillance System in Gadarif State, Sudan, in 2024, with specific objectives to assess the core surveillance functions and supportive activities at three administrative levels, Health Facilities (HFs), Heads of Localities, and the State Ministry of Health (SMoH).A cross-sectional study followed by a one-group pre-test post-test intervention design.The study population included surveillance sentinel sites and health workers operating within the NTD surveillance system across 12 localities in Gadarif State. Data were collected from 19 Health Facility Surveillance Units (HFSUs) and 12 locality units using a modified and adapted version of the World Health Organization (WHO) surveillance system evaluation questionnaire. The process involved three phases: preparatory (literature review and tool development), operational (data collection), and analytical (data analysis using the Statistical Package for Social Sciences SPSS and Kobo Toolbox). The assessment focused on core surveillance functions (case detection, confirmation, and response) and supportive functions (training, supervision, and resource availability).Pre-intervention findings showed high compliance with core activities at the HF level, where all 19 HFs (100%) had mechanisms to capture unusual events and ensured prompt sample submission. However, 10.53% of staff had not received training in disease surveillance and response. At the locality level, 91.67% had standardized case definitions, and 83.33% maintained a rumor register. Post-intervention assessment at the SMoH level demonstrated 100% compliance across all core and supportive functions, including the presence of a rapid response team, comprehensive training plans, and functional communication facilities—indicating substantial system improvement following the intervention.Sudan’s persistent NTDs burden is compounded by fragmented and resource-limited surveillance systems. The evaluation demonstrated that targeted interventions can significantly strengthen surveillance capacity, particularly at the state level. Sustained commitment from national authorities, donors, and communities is crucial to integrating NTDs surveillance within the Primary Health Care (PHC) framework, thereby reducing disease burden and enhancing outbreak response capacity.