The Duke Clergy Health Initiative began in 2007. Its mission is to understand and improve the holistic health of United Methodist clergy in North Carolina. The Initiative has developed, conducted, and tested 3 interventions, including an intervention targeting metabolic syndrome and depression tested with over 1,100 clergy in a randomized controlled trial design. The Initiative includes a longitudinal panel survey on health and well-being conducted in 2008, 2010, 2012, 2014, and 2016, as well as a mixed methods study seeking to determine how some pastors sustain high positive mental health. Recent work has focused on analysis and dissemination of intervention results, positive mental health findings, and contributions to the literature on the interplay between physical and mental health and spiritual well-being.