Vending machines are a common source for low nutrient, energy-dense snacks and beverages and youth can easily access vending machines at many public spaces such as parks, recreation centers, and swimming pools. Many cities are beginning to adopt healthy vending policies in public areas, but evidence regarding best practices for developing, implementing, and evaluating these healthy vending polices is limited. This study used a mixed-methods, multiple case study design and included semi-structured interviews with multiple stakeholders from each city; site visits at each city, which included intercept surveys with adults using the vending machines and observations of the available products in vending machines; and a review of documents including nutrition standards, policies, requests for proposals (RFPs), vending contracts, sales data, and any existing evaluation tools were collected from each site. This report describes the major similarities and differences across four cites/counties implementing healthy vending initiatives and emphasize the major facilitators and barriers to developing, implementing, and evaluating healthy vending policies and initiatives.