In spite of the fact that nonphysician anesthesia providers are used in many areas of the world, some countries continue to have shortages in the anesthesia workforce. As a result of many requests from around the world for information on starting a nurse anesthesia program, the Education Committee of the International Federation of Nurse Anesthetists (IFNA) developed a document entitled "Guidelines for Starting A New Program and Sample Curriculum." It was hoped that this document, along with IFNA's "Educational Standards for Preparing Nurse Anesthetists," would be of assistance to individuals starting programs internationally. This article is a case example of necessary steps in establishing a nurse anesthesia program. In addition to beginning stages and organization of the school, it describes the challenges encountered. It highlights the importance of follow-up and continued assistance for success of new programs.