Health conferences are established structural elements in the field of health prevention and health-care in North Rhine-Westphalia. This applies to the state level (state health conferences) as well as to the municipal and city levels of government (local health conferences). After being tested in a pilot project in the period 1995-1998, the foundation of local conferences became obligatory in all municipalities when the public health service act of 1998 came into effect. The present article describes the relevant structures, developments and results.