This article discusses the limits and possibilities in the implementation of health promotion and surveillance measures, in light of the regionalization proposal contained in the Health Care Operational Norm (NOAS) adopted by the Brazilian Ministry of Health in 2001. The proposal is characterized as an opportunity to move forward in the establishment of micro-regional systems guaranteeing integral health care, in keeping with the operational capacity of the Unified National Health System in each Region and State of the country. The article goes on to analyze the contribution of various proposals for change in health practices for the development of health promotion, prevention of risks and diseases, and reorientation of individual and collective care as they are incorporated into the NOAS implementation process in various States of the country.