Oil and natural gas are the largest primary global energy sources, and upstream gas emissions from these fuels can impact global climate change and local public health. This paper employs a public health-oriented perspective that reviews grey and academic literature, industry data, technical reports, and policy trends to highlight issues of emissions monitoring. We identify gaps in the existing landscape of emissions reduction strategies and highlight options for addressing them. Policy recommendations include the use of new digital monitoring technologies to better understand causes of emission events, to create data-driven oil and gas regulations, and to begin accurately measuring the volumes of gases released during oil and gas production. Areas for future research relating to emissions and public health impacts are outlined to further enable oil and gas policy discussions.