Throughout its 25-year history, the North Carolina Institute of Medicine (NCIOM) has played a major role in shaping policies to improve the health of North Carolinians. The work of the NCIOM, individual task force members, and partnering organizations has led to positive changes in public and private health policies and the availability and delivery of health care services. These changes have improved health care access and quality of care for millions of North Carolinians. This publication looks at the history and accomplishments of the NCIOM over the past 25 years.