In April 2007, more than 50 practitioners, advocates, funders, and evaluators met for 2 days in Pittsburgh, Pennsylvania, to discuss the issues that arise in evaluating systems change or systems-building initiatives and to suggest approaches to resolving those issues. The symposium was designed to be as realistic and practical as possible by focusing discussion and problem solving on a case study of a hypothetical systems-building initiative aimed at improving early childhood outcomes. (Contains 2 notes.)