One of the central challenges facing today's state transportation policymakers is how to incorporate preventive maintenance concepts and strategies into existing asset-management systems. Seven unique challenges to implementing preventive maintenance are identified in the literature and elsewhere, and a discussion covers the ways states have addressed those challenges through various implementation strategies. Then, case studies provide examples of how that incorporation has occurred in the departments of transportation in Michigan, Kansas, and Nebraska. The three case studies are presented in an effort to demonstrate the advantages and disadvantages of these three unique approaches, herein labeled the top-down approach, for Michigan; the bottom-up approach, for Kansas; and the inclusive approach, for Nebraska. In particular, an examination is presented of how preventive maintenance concepts were integrated into the planning, budgeting, and technical needs-assessment for state highways.