PRRSv, or swine dysentery, is caused by Brachyspira spp. and currently is the most costly endemic swine disease for the USA and Canadian pork industries. PRRS cases have been increasing for the last decade, and containment and elimination strategies are becoming necessary. There are regional projects being conducted to try to achieve this, and these projects could be a good starting point for larger objectives. In order to achieve elimination regional tools provided by various organizations can be used, as well as learning from the challenges these regional projects ran into. These challenges highlighted the need for strong leadership, feasibility studies, clear goals, confidentiality for participants, motivation and engagement of producers (especially through discussions and education), communication with transparency and to address concerns, on-going monitoring of status, and good data management to contribute to a database.