There has been a surge in experience-based co-design (EBCD) efforts for quality improvement in health care and systems design globally. Service users together with staff are playing a far greater role than ever before in the redesign of services and systems of care. EBCD offers a systematic, bottom-up approach to improving service user and staff experiences of care. There is growing interest in the application and potential of EBCD; however, studies indicate common shared challenges, which coalesce around power, commitment to the process, methods for gathering experiences, designing improvements, implementation, and subsequent impact.