Health Investigations Branch, Division of Health Studies, Agency for Toxic Substances and Disease Registry, USA As a public health agency within the US Department of Health and Human Services, the Agency for Toxic Substances and Disease Registry (ATSDR) is responsible for implementing the health-related provisions of the Superfund Act. Much of its work is carried out to address health concerns in communities near sources of environmental contamination, usually in consultation with other local, state, and federal agencies. Over the last decade, ATSDR has considered, supported or conducted health investigations in a variety of different communities across the country. Communication with community residents has been an integral part of the process in all of these activities. The approach to communicating results needs to begin early by developing relationships and clarifying expectations, and it needs to remain flexible. Through examples taken from specific situations, we illustrate many of the lessons we have gained from trying to apply the principles of good community involvement to the design and conduct of health investigations and to the communication of study results.