This report examines the Neighborhood Transformation Initiative's (NT) first decade and draws a series of lessons from the successes and struggles of this partnership among the Enterprise Foundation, the city of Baltimore, and the residents of the Sandtown-Winchester neighborhood. Launched in 1990, NT was one of the first systematic attempts to bring together diverse strategies to change the conditions that undermine impoverished communities. These strategies focus on: physical development, economic development, health, education, family support, substance abuse, crime and safety, and community pride and spirit. The report highlights NT's notable achievements and discusses the role played by each party. Most of the major complexities involved in comprehensive community development played out in Sandtown-Winchester, reflecting both the relevance of NT and its potential to contribute to the evolving theory and practice in the field. Some of the lessons reinforce NT's decisions about design and implementation, while others suggest alternative approaches. Also included is a discussion of the abiding challenges that inevitably arise in partnerships like NT, which involve poor communities and powerful institutions outside those communities.