Implemented 10 years ago, the French syndromic surveillance system Oscour, based on emergency departments, has been assessed using four major evaluation criteria in syndromic surveillance: stability and regularity of data transmission, the coverage at the national level, data quality, particularly for medical information and the utility of the system for the public health surveillance. In 2014, about 40,000 daily attendances are extracted automatically from 600 ED departments located all over the territory, covering 80% of the national attendances. About 12,800 different ICD10 codes have been used in 2013, enabling a large public health surveillance.