OBJECTIVES: We aimed to evaluate the trends of submissions and recommendations received and emitted by the Brazilian Commission on Health Technology Incorporation (CITEC) during the process of adoption/exclusion of technologies on the country’s Public Health System and to critically appraise this process and to analyze the challenges this commission faces in responding to the increased demand for incorporation of new technologies. METHODS: All submissions on health technologies made to CITEC and the respective responses obtained between 2003 and 2010 were reviewed.They were classified by field of interest, origin of request and type of response. RESULTS: During the selected period CITEC received 222 proposals for technology incorporation and produced 83 recommendations. We identified an increase in submissions after 2007. From 2003 to 2006, only 39 requests were submitted on total. After 2007, an average of 49 submissions per year was made. The main fields were endocrine and metabolic disorders (12%), Oncology (11%) and Rheumatology (11%), but the percentage of responses in these fields was low (34%, 8% and 28% respectively). More than 70% of the submissions were commissioned by the Industry (162), but only 27% of these were answered. However, almost all submissions sent directly by the Ministry of Health were answered (94%). Among recommendations from CITEC, 53% were favorable to the incorporation of the new technology and 30% were contrary to it, 17% were cancelled submissions. Adopted technologies were mainly for hepatitis (14%), endocrine and metabolic disorders (11%) and genetic disorders (11%). CONCLUSIONS: Although there isn’t a clear definition of priorities for the incorporation of new technologies by the Brazilian Ministry of Health, it is possible to map trends in the recommendations issued by CITEC. It is of the utmost importance to achieve greater disclosure of the criteria for selection of technologies for incorporation by the Commission.