Scenario analysis is a strategic planning technique used to describe and evaluate an organization's external environment. A methodology for conducting scenario analysis using the Jefferson County Department of Health and the national, State, and county issues confronting it is outlined. Key health care and organizational issues were identified using published sources, focus groups, questionnaires, and personal interviews. The most important of these issues were selected by asking health department managers to evaluate the issues according to their probability of occurrence and likely impact on the health department. The high-probability, high-impact issues formed the basis for developing scenario logics that constitute the story line holding the scenario together. The results were a set of plausible scenarios that aided in strategic planning, encouraged strategic thinking among managers, eliminated or reduced surprise about environmental changes, and improved managerial discussion and communication.