Background <p>Based on the failure of surveillance for COVID-19, this research focuses on the surveillance information reporting for public health emergencies under the online direct reporting system, exploring how to improve the timeliness and accuracy of public health emergencies surveillance through the effective combination of technical advantages with management mechanism.</p> Methods <p>We construct an evolutionary game model of surveillance information reporting for public health emergencies based on the local government, Centers for Disease Control and Prevention (CDCP) and medical institution, using numerical simulation to simulate the operating status of the game system and summarize the key factors to improve the effectiveness of public health emergencies surveillance.</p> Results <p>The results indicate that medical institution’s ability to surveillance information management, the capabilities of CDCP to risk assessment, the degree of cooperation between CDCP and medical institution, the degree of collaborative linkage between the local government and CDCP, and the coverage of surveillance information have the greatest impacts on the subjects’ strategies, which in turn affects whether abnormalities can be timely and accurately reported. The enthusiasm of medical institution and CDCP to participate in surveillance information reporting is positively related to their own capabilities, but improving one party’s capabilities will reduce the enthusiasm of the other party. Strengthening the cooperation between CDCP and medical institution helps them choose positive strategies, and the collaborative linkage between CDCP and the local government helps the system eventually reach stability with the strategy combination of (1, 1, 1). Expanding the coverage of surveillance information provides convenience for CDCP and the government, but also causes medical institution reduce the speed of converging on positive management.</p> Conclusions <p>The development of technological advantages requires a management system as a guarantee. First, improving the professional capabilities of medical institution and CDCP is a prerequisite for carrying out public health emergencies surveillance. Second, CDCP should pay attention to communicating with the local government and medical institution, achieving vertical information sharing among subjects. Furthermore, the local government should horizontally expand the information sources to ensure the information in the online direct reporting system is true and accurate.</p> Trial registration <p>Not applicable.</p>