In 1994, the Program for Health Care to Underserved Populations (PHCUP) was founded as a program under the auspices of the University of Pittsburgh’s Division of General Internal Medicine, with its primary mission to reduce health disparities and provide quality and compassionate health, pharmaceutical and social services care to uninsured and vulnerable individuals. The initial efforts of the PHCUP, led by Dr. Thomas P. O’Toole at the Division of General Internal Medicine and Paul J. Freyder at The Salvation Army of Pittsburgh, were to respond to evaluating and treating the medical conditions of homeless and uninsured individuals. To address these concerns, the PHCUP and Salvation Army created a free-care, volunteer staffed, medical clinic at the Army’s homeless drop-in center on the South Side of Pittsburgh. Named the Birmingham Free Clinic (BFC), to reflect the rich history of Pittsburgh’s South Side, this clinic is the Program’s longest-running initiative. Since this first effort, the PHCUP has expanded in infrastructure, scope, and quality improvement activities to serve the greater Pittsburgh community. The PHCUP partners with additional community agencies throughout the Pittsburgh area, including the Women’s Center and Shelter of Greater Pittsburgh, The Salvation Army Harbor Light Center, The Salvation Army Northside Clinic, the Health Care for the Homeless Project and the Grace Lamsam Pharmaceutical Program of the University of Pittsburgh. Based on these collaborations, the PHCUP now serves a very diverse patient population, including uninsured individuals who may be working but low-income, those across the spectrum of homelessness, individuals in drug and alcohol and other drug treatment, individuals with co-occurring disorders and victims of intimate partner violence.