AMR is an escalating One Health threat with major implications for human health and animal production. Surveillance data is essential to monitor trends, guide antimicrobial stewardship (AMS), and inform policy and investment decisions. However, animal health AMR surveillance in low- and middle-income countries (LMICs) is resource-intensive, and sustainability beyond donor support remains a central challenge. This report, prepared as the Fleming Fund concludes in 2026, reviews the effectiveness, cost‑efficiency, and sustainability of different animal health AMR surveillance strategies, including farm-based, abattoir, opportunistic, and wastewater sampling. We have explored these questions through case studies carried out in Zambia and Nepal.