In 2004 the Government of Nepal launched the Intensification of Maternal and Neonatal Micronutrient Program, more commonly called the Iron Intensification Project, in five districts. This case study describes the development of the project, its design, the process used to implement it at the district level, the strategy used to scale it up, and the data available to describe coverage. The reduction in maternal anemia in the country between 1998 and 2006 is also described. Conclusions are drawn regarding lessons learned for sustaining and strengthening the program in Nepal as well as the usefulness of the program model for translation to other countries.