Electronic exchange of sanitary and phytosanitary certificates can facilitate trade in animal and plant products. The electronic exchange of certificates can benefit both exporting and importing countries through enhanced efficiency gains, improved transparency, and traceability, as well as improved risk management along the food chain. However, the policy levers associated with e-sanitary certification systems are complex and include trade policies, as well as regulatory policies, investment policies, and public health and animal health policies. Countries face substantial challenges in the adoption of electronic sanitary certification systems including the costs associated with building the infrastructure, providing training, and updating existing regulatory systems. This paper reviews the uptake of e-sanitary certification systems and discusses the potential benefits and costs of adoption of these systems. Effective co-operation and collaboration between the public and private sectors are critical to the adoption and maintenance of sustainable e-sanitary certification systems.