Health Actions Zones (HAZs) have been identified as initiatives reflecting the 'third way' policies espoused by the UK New Labour Government. Like other area-based or zone initiatives, HAZ programmes are designed to tackle inequalities and exclusion in some of the most deprived areas of the UK. This is to be achieved through partnerships between the public, private and voluntary sectors, and most significantly, communities themselves. Health Action Zones embrace communities and attempt to foster involvement in health improvement, often using established community development models. The present paper uses the findings of an ongoing process study into the development of one zone in the north-east of England to consider community involvement in practice. The benefits and challenges of involving communities in the HAZ process are presented, and the relevance of this for future programmes and policy are discussed.