This study takes an in-depth look at Montana’s public health system and gives recommendations for strengthening it. The study is the result of a year-long project by the National Network of Public Health Institutes and Population Health Partners. It is the culmination of over 50,000 miles of travel, three regional roundtable discussions, and many interviews, meetings, and site visits. This project was an excellent opportunity for us to work with public health professionals and community members across the state. We hope the report will serve as a resource to inform strategies for strengthening Montana’s public health system moving forward.