This first-of-its-kind qualitative study explores the development of Mayo Clinic’s animal assisted services (AAS) program through semi-structured interviews with leaders and program architects. Participants reflected on the therapeutic impact of the human-animal bond for patients, families, and staff, as well as the organizational conditions that shaped this impact and program success. Key themes included leadership and administrative support, strategies to build institutional trust, ethical stewardship of animal partners, quality control, and the role of education and research in sustaining growth. By documenting experiential knowledge from an established program, these findings offer practical insights that may inform and streamline the development of evidence-aligned hospital-based AAS programs across healthcare settings.