The Global Burden of Disease in 2023 represents the most comprehensive edition of its kind since the first report in 1993. Despite improvements in health monitoring, data collection and analytical methods, its expansion creates new challenges and opportunities. These challenges relate to improving the accuracy, completeness, external validity and policy relevance of the report. In an editorial, author Zulfiqar A. Bhutta discusses the Global Burden of Disease (GBD) report to 2023. He gives reasons why further expansion of GBD poses new challenges despite advances in monitoring and analysis. The report thus highlights the need for increasing collaboration to address these aspects.