Accountability within the integrated care movement is increasingly recognized as distinct from traditional models of accountability in health and care organizations. But in what ways is it different, and to what extent have these new accountability features been embraced by organizations and systems advancing toward integrated care? These are the central questions this chapter addresses. The chapter has two primary aims. First, it proposes five working propositions that define the core features of accountability in integrated care, highlighting the added value it brings to conventional accountability frameworks. Second, it presents an empirical analysis of how accountability practices have evolved in four national and regional integrated care systems across Europe. The findings suggest that, despite progress, there is still a long way to go to move from traditional forms of accountability to a distinctive integrated care accountability approach and style.