There is a need for pragmatic and rigorous research designs to evaluate the effectiveness of population-based health interventions. The randomized controlled trial (RCT) has limitations in its practicality, ethical appropriateness, and cost when evaluating population-based interventions. Like RCTs, the multiple baseline design can demonstrate that a change in behavior has occurred, the change is a result of the intervention, and the change is significant. Especially important practical advantages over the RCT are that this design requires fewer population groups and communities may act as their own controls. Advantages and methodologic limitations of the multiple baseline design are discussed, and where feasible, strategies to minimize the impact of its limitations are suggested. Recommendations for future research are included.