The second largest city in Saudi Arabia, Jeddah faces challenges common to modern cities: population growth, environmental stress, infrastructure challenges, and bureaucracy. It became apparent that a strategy, and a methodology to execute it, were needed to break through the limitations it was facing. Since adopting the Balanced Scorecard, the level of citizen satisfaction with city services has improved by nearly 300%, dengue fever has nearly been eradicated, evaluation of city cleanliness has improved 80%, the percent of cleaning projects completed has doubled, and employee satisfaction has more than doubled.