A stellar track record led to his appointment as director of the National Heart and Lung Institute, a position he held for two decades. At the helm of the Institute he identified priorities and developed implementation plans, which included the input and participation of other NIH disciplines and professional societies—at the time a somewhat novel idea. Dr Lenfant brought the Institute into the modern era of science with initiatives including Programs of Excellence in Molecular Biology, the Proteomics Initiative, and the NIH’s first gene therapy protocol. He presided over the Institute’s development of a National Center on Sleep Disorders Research, and management of the Women’s Health Initiative. Under his watch, large-scale multicenter landmark clinical trials were conducted that improved understanding and practice. The nation’s commitment to alleviate heart, lung, and blood disorders, and to fund blood safety research, expanded as he persuaded Congress to increase the NHLBI budget from $500,000 to nearly $3 billion.