The U.S. Department of Defense (DoD) has made significant strides toward improving its efforts in global health engagement (GHE) to include an emphasized requirement for monitoring and evaluation (M&E) of GHE activities. However, a renewed push is needed to capitalize on over a decade of improved perspective on global health and turn it into action at the medical planning and execution levels. The lack of consistent and persistent, quality M&E has limited the ability to clearly demonstrate the objective value of the U.S. military application of the discipline of global health - aka, global health engagement. We suspect that GHE is undervalued in its ability to achieve goals in both security cooperation and global health but do not have well-documented evidence to prove that hypothesis. Multiple challenges and barriers stand in the way of high-quality M&E, to include a lack of dedicated resources; inconsistent and disparate data input and collection across the DoD; non-standardized after action reports for GHE that do not contribute to high-quality evaluation; and the challenges of incorporating relevant metrics into the joint planning process that can be followed up longitudinally.