In October 1993, the Prince Edward Island government proclaimed a new Health and Community Services Act which radically altered the structure of health service delivery and governance across the province. This research examines the extent to which the principles of health regionalization have been achieved in the 8 years following the restructuring. Based on a survey of present board members and CEOs, interviews of board chairs, vice chairs and CEOs and an extensive review of the literature, this research provides the framework and background against which to analyze regional health governance in Prince Edward Island. Governance issues including: credibility, role, responsibility, authority and accountability of regional health boards in this province have been examined.