We discuss the benefits of maintaining an active, rigorous, and highly structured grand rounds (GR) program in an academic radiology department. These benefits include education for faculty (continuing medical education), fellows, and residents and a venue for building collaboration and camaraderie within the department and institution, while also allowing for building ties with the radiology community at large. In addition, we illustrate how to build and sustain a dynamic GR program based on our collective 6-year experience in running such a program at our institution that has offered more than 180 GR and hosted more than 90 visiting professors during this period. Maintaining such a program requires infrastructure, financial support, careful planning, and considerable effort. We believe that this article can serve as a " how-to" guide or framework to initiate and maintain such a program. © 2012 AUR.