Health programs based solely on vaccination and treatment regimens are often short-lived and unrewarding. The basis of any successful ongoing health program is a working health management system. The key to the success of the system is a functioning record system that generates information meaningful to management. The basic information generated should include morbidity and mortality data categorized by cause, the number of repeat treatments, and the number of chronic animals or railers. Goals should be set for each major category so that a database can be established for a feedlot operation to assess problems and progress. The most common reason for expectations not being achieved is factors that are largely beyond the control of the feed yard. Although attempts to address these factors should be periodically reviewed, attention to the health program and potential modifications are among the factors that we can control and modify as appropriate. BRD is the most important economic disease in the feedlot. Prearrival management is extremely important in assessing the risk category of incoming calves and in applying a preventive health strategy. Good husbandry, proper nutrition, proper pen maintenance, and selective immunization help to ensure that the cattle adapt quickly to the feed yard environment. Careful observation, timely effective therapy, and excellent hospital management increase the opportunity to produce cost-competitive, safe, and wholesome beef in a humane fashion with limited effects of the environment.