Large-scale food fortification (LSFF) has emerged as an important strategy for addressing micronutrient deficiencies and improving nutrition at population scale. Yet, translating policy commitments into effective, sustainable programs requires more than establishing fortification standards. It depends on strong regulatory and quality assurance systems, capable local industries, reliable supply chains, effective monitoring, and the ability to reach populations through existing public platforms. Across Africa, Asia, and Latin America, countries have developed diverse approaches to addressing these challenges, offering valuable lessons for others navigating similar pathways. This report brings together evidence and experiences from 16 countries to highlight what is working, where gaps remain, and how countries can learn from one another to strengthen more sustainable and locally owned approaches to LSFF.