SummaryA method of monitoring the incidence of malformations is described. It is suitable for systems where the number of births between successive malformations is known or can be estimated with reasonable accuracy. The method utilises a cusum technique based on the exponential distribution to detect an increase in the incidence of malformations above a baseline level. Adequate information to enable the implementation of the method is presented. The proposed method compares favourably with others such as the Poisson cusum and the modified sets technique.