Despite extensive discussion of the technological possibilities and public health importance of metagenomic sequencing, there has been scant discussion of what policy and regulatory issues need to be addressed to realize the potential of metagenomic sequencing . Here we review the current state of biosurveillance, and point to several ways future metagenomic monitoring may replace currently limited infectious disease monitoring models. We suggest that while many key enablers are technological, others are not. We therefore highlight key policy challenges and implementation questions which need to be addressed in order for the world to reach a state of ‘Widespread Metagenomic Monitoring’. We find that policymakers must address pitfalls like fragmentation of the technological base, private capture of benefits, privacy concerns, the usefulness of the system during non-pandemic times, and how the future systems will enable better response. If these challenges are addressed, the technological and public health promise of metagenomic sequencing can be realized.