The need to prevent falls and related injuries among seniors is a significant public health issue in Canada and all nations where an aging demographic puts higher numbers at risk. In British Columbia (BC), falls are the leading cause of injury-related hospitalization and death among seniors. Seniors are BC’s fastest growing age group, with one in four reaching the age of 65 or older by 2036. To address this costly and complex problem, a sustained collaboration has occurred over the past 20 years among fall prevention leaders within government, the health system, academia and local communities. This article summarizes key elements of a coordinated, province-wide public health approach to reduce falls and related injuries among those aged 65 years and older in BC. Historical records of the interventions are recorded in two influential reports that have also helped to galvanize this province-wide collaborative effort. Outcomes include a significant reduction in fall-related hospitalization and death rates, with a parallel growth in fall prevention programs and services for those at risk. This article concludes with a summary of the key developments in the evolution of fall prevention activities in the province over the past two decades and how the sustained, collaborative efforts have resulted in BC emerging as an example of success in the formation of comprehensive networks and the integration of evidence-based fall prevention into health service delivery for seniors. However, more needs to be done to ensure integrated and sustained results.