A university health center was faced with the challenge of ensuring long-term sustainability. A project was undertaken to assess and implement administrative and financial strategic initiatives that would support and ensure sustainability. As a result of these initiatives, primary care services reflective of the mission of the University would continue to be provided to students, faculty, staff, and community members in a fiscally responsible manner. Client outcomes were also identified through the measurement of quality indicators and patient satisfaction. Financial stability was a major impact of the project. After several years of experiencing significant financial loss, a cost assessment was conducted; as a result, the operations of the Health Center now demonstrate fiscal responsibility.