Shiga toxin-producing Escherichia coli (STEC) infections are a substantial health issue worldwide. Circa 2010, foodborne STEC caused > 1 million human illnesses, 128 deaths, and 13,000 Disability Adjusted Life Years (DALYs). Targeting interventions to address this hazard relies on identifying those STEC strains of greatest risk to human health and determining the food vehicles for such infections. This report brings together the review and analysis of existing information on the burden, source attribution, hazard characterization and monitoring of STEC. It proposes a set of criteria for categorizing the potential risk of severity of illness associated with the presence of a STEC in food, for consideration by risk managers, as part of a risk-based approach to control STEC in foods. It presents the initial results on source attribution of foodborne STEC, highlighting that while ruminants and other land animals are considered the main reservoirs for STEC, largescale outbreaks have also been linked to other foods, such as fresh produce. It also provides a review of monitoring programs and methodology for STEC, which can serve as a reference for countries planning to develop such programs.