Introduction: Accreditation of local health departments (LHDs) is already a reality in many states, and with the establishment of the Public Health Accreditation Board, a national voluntary accreditation program will be forthcoming. To help prepare LHDs for accreditation, the National Association of County and City Health Officials has developed a self-assessment instrument on the basis of the Operational Definition of a Functioning Local Health Department. Methods: The article is a case study, describing the inputs, processes, and outputs of using the self-assessment in an LHD in a manner that can be applicable to other settings. Results: A seven-member work group conducted the self-assessment over an 11-week period, providing a total of 184 person-hours, with an equivalent cost of $8 565. The self-assessment was scored on the basis of indicators of performance of Essential Services and Standards. There were significant correlations between the scores on Essential Services and Standards with the scores on the documentary evidence that the indicators were being met (r = 0.7545, P = .0117; r = .7264, P < .0001, respectively). Conclusion: Overall, the workgroup found the self-assessment tool to be useful, particularly for emphasizing the importance of documentation, and the process of conducting the self-assessment valuable for accreditation preparedness and for improving current internal communications and work practices. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.