With fifteen incorporated municipalities in its borders, Gaston County has mastered the art of collaborative leadership in order to provide residents with healthy living opportunities. For instance, Gaston County requires that new subdivisions include sidewalks when they border areas of cities’ projected growth, in order to create more seamless development patterns with sidewalk and bicycle facilities that connect to reachable destinations. The county also spearheaded regional efforts to develop the Carolina Thread Trail, convening a diverse steering committee, engaging the public, and creating a master plan in coordination with municipalities. Community partners in health, recreation, and horticulture offer a broad array of structured physical activity and healthy eating programs in which residents can participate. Building upon such successes, county leaders recently passed a policy calling upon diverse local stakeholders to implement policies and practices to increase physical activity and healthy eating, and provided a set of policy recommendations to support stakeholders in their efforts.