The Society for Vascular Surgery Vascular Quality Initiative (SVS VQI) is designed to improve the quality, safety, effectiveness, and cost of vascular health care. The SVS VQI is uniquely organized as a distributed network of regional quality improvement groups across the United States. The regional approach allows for the involvement of a variety of health care professionals, the pooling of available resources and expertise, and serves as a motivating factor for each participating institution. Regional quality group sizes, administrative structure, and meeting logistics vary according to geography and regional needs. This review describes the process of forming, growing, and maintaining a regional quality improvement group of the SVS VQI. © 2013 Society for Vascular Surgery.