When Donald A.B. Lindberg M.D. was sworn in as Director of the National Library of Medicine (NLM) in 1984, MEDLINE, NLM’s online database of citations and abstracts to biomedical journal articles, was searched primarily by librarians trained to use its command language interface. There were fees for searching, primarily to recover the cost of using commercial value-added telecommunications networks. Thirteen years later, in 1997, MEDLINE became free to anyone with an Internet connection and a Web browser. This chapter provides an insider’s view of how Dr. Lindberg’s vision and leadership – combined with new technology, astute handling of policy issues, and key help from political supporters and influential advocates – enabled a tremendous expansion in access to biomedical and health information for scientists, health professionals, patients, and the public.