The governance institutions in South Africa saw immense change in structure and application after 1994, based on an expanded number of provinces and determining district- and metropolitan government municipalities. The post-apartheid instruction of spatial transformation was provided through various pieces of legislation and policy, but the application thereof differs significantly when applied to this intermediate level of regional governance. The Constitution of South Africa clearly spells out the statutory role local government must play as a decision-maker on spatial planning matters—the role of regional governance is much more an advisory and compliance role in facilitating spatial planning and the resultant focus of transformation. This chapter aims to reflect on the changed regional planning landscape in South Africa over the last three decades and evaluate the existing structures and instruments focused on spatial transformation. The policy and legislation available to regional governments will be analysed against the backdrop of effective spatial transformation. Furthermore, this chapter will explore case studies as a form of multi-level governance (MLG) and a potential tool for more effective regional governance towards a more transformed national space.