Healthy city programs have been implemented in countries of the WHO Eastern Mediterranean Region for 20 years. However, no universal systematic approach for the implementation of the healthy city program has been established. World Health Day 2010 provided the opportunity to push forward the urbanization and health agenda by securing the political commitment of more than 200 cities in the Region. Entrance into the regional healthy city network is contingent upon meeting certain criteria that qualify a city as a "healthy city". This concise, simple and practical guide is intended to help countries standardize their methods, mechanisms and processes of implementation of the healthy city program and is particularly targeted at members of healthy city coordinating committees and program trainers, as well as partners.