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Accurate surveillance of work-related injuries is needed at national and state levels. We used multiple sources for surveillance of work-related amputations, compared findings with Survey of Occupational Injuries and Illnesses (SOII) estimates, and assessed generalizability to national surveillance.Three data sources were used to enumerate work-related amputations in Massachusetts, 2007–2008. SOII eligible amputations were compared with SOII estimates.787 amputations were enumerated, 52% ascertained through hospital records only, exceeding the SOII estimate (n = 210). The estimated SOII undercount was 48% (95% CI: 36–61%). Additional amputations were reported in SOII as other injuries, accounting for about half the undercount. Proportionately more SOII estimated than multisource cases were in manufacturing and fewer in smaller establishments.Multisource surveillance enhanced our ability to document work-related amputations in Massachusetts. While not feasible to implement for work-related conditions nationwide, it is useful in states. Better understanding of potential biases in SOII is needed. Am. J. Ind. Med. 57:1120–1132, 2014. © 2014 Wiley Periodicals, Inc.