Background: Scalp cooling is a useful technique for decreasing hair loss and reducing the stigma patients feel when they experience alopecia. It was used for a period of time in the U.S. more than 20 years ago and then was removed from the market while use continued in Europe. Recently, better equipment has been developed and approved by the FDA for use with patients who have solid tumors. Current evidence supports this technology and will be summarized in this presentation. Discussion: Setting up scalp cooling as an offered service at any setting presents many challenges and changes in workflow affecting physicians and nursing staff. The purpose of this presentation is to prepare oncology providers who wish to implement scalp cooling using a machine based system at their setting. Our implementation process will be used as a teaching case study. Product support, logistics, patient satisfaction, equipment, and education needs will be discussed. This project description will highlight the steps taken to implement scalp cooling at a comprehensive cancer center for breast and gynecology oncology patients. Initial efforts to review the literature, investigate equipment choices, and compare use with other centers will be reviewed. The management aspects of setting up a new service, eg, business plan, physical plan considerations, informed consent, costs, staffing, workflow, clinic schedules, safety, and staff education will be shared. Important tips for keeping patients safe and comfortable while achieving maximum therapeutic benefit will be discussed. Evaluation will be presented in the form of lessons learned during implementation resulting in more efficient work flow and greater patient comfort during scalp cooling. Patient satisfaction data will be disseminated. Conclusion: The oncology community is eager to provide patients with scalp cooling, but no literature to date has described the management aspects of implementation. This presentation will offer comprehensive information to assist in addressing anticipated needs when initiating scalp cooling.