Drug-related infectious diseases (DRID), such as HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV), contribute to high morbidity and mortality among people who inject drugs (PWID). The European Union Drugs Agency (EUDA) is responsible for monitoring DRID and related behaviours for PWID in Europe. We updated the EUDA DRID technical protocol which covers all steps from planning to data analysis needed for a survey among PWID. Drug-related infectious disease-specific indicators were revised. To enable a more effective monitoring of the current epidemiological situation, we added specific core indicators, such as prevalence of viraemic HBV, HCV and HIV care cascades and harm reduction-related indicators. HIV pre-exposure prophylaxis and take-home naloxone were added as optional indicators. The process was informed by a European working group, who shared best-practice examples of (repeated) cross-sectional and cohort surveys using different methods in various settings. To reach the World Health Organization's goal of ending HIV and the viral hepatitis epidemics, comprehensive DRID monitoring among the disproportionately affected PWID population is needed.