OBJECTIVES: To identify and describe the steps and strategies that community pharmacies with established medication management services have used to integrate medication management services into their practice settings. DESIGN: Qualitative case study with semi-structured interviews and focus groups. SETTING: Community pharmacy organizations in Minnesota. PARTICIPANTS: Pharmacists and pharmacy leadership from 4 different pharmacy organizations including independent, chain, and health system pharmacies. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Qualitative case study analysis of community pharmacy management and pharmacists' perceptions of the factors that led to the establishment and sustainability of their medication management programs. RESULTS: Focus groups and interviews were undertaken with 25 pharmacists and pharmacy leaders from 4 distinct community pharmacy organizations from April to June 2015. Five themes emerged, representing specific implementation and continuation stages of medication management services in community practice: Deciding to Act, Setting the Stage, Executing the Service, Sticking to It, and Continuing to Grow. CONCLUSION: This study sheds light on key stages that have commonly occurred across community pharmacies that are delivering medication management services. The results of this work may serve as a road map for other community pharmacies looking to integrate medication management services into their own practice settings.