Integrating behavioral health services within the pediatric primary care setting provides an opportunity to address the increasing prevalence of mental health and behavioral concerns among children and adolescents. This chapter provides a user-friendly overview of the implementation process for establishing an IBH service in pediatric primary care settings covering three key phases: Assessment and Planning, Implementation, and Evaluation and Refinement. Within each phase, we review key objectives and offer suggestions for achieving them with an emphasis on flexibility to align with the specific characteristics of your pediatric primary care environment. In recognition that provider and physician training is an essential component of a successful IBH service, the chapter reviews the core competencies required for effective IBH delivery. By following these guidelines, pediatric primary care teams can establish successful IBH services within their clinics, enhancing patient satisfaction and overall health outcomes.