The Federal Reserve Bank of San Francisco, in partnership with the Robert Wood Johnson Foundation, launched the “Healthy Communities” initiative in 2010 to explore how the health and community development sectors can collaborate. A regional meeting took place in Las Vegas in January 2012, which led to the formation of the Las Vegas Healthy Communities Coalition (LVHCC), a collective impact initiative with a mission to “foster collaboration and coordination across multiple sectors and stakeholders, to generate healthy outcomes for all Southern Nevadans.” This report details the formation and progress of LVHCC, which is still in the early stages of development. Unlike other case studies, which often report on an initiative’s success after many years of careful planning and implementation, this study aims to provide a candid look at the challenging and emergent nature of cross-sector collaboration in progress. It is meant to shed light on specific challenges and lessons that have been learned in Las Vegas thus far in order to help other communities that have embarked on their own community collaboratives.