The ongoing European Prevention of Alzheimer’s Dementia Programme (EPAD) was established in 2015 to create a platform for Phase 2 testing of interventions for the secondary prevention of Alzheimer’s disease (AD) dementia. This initiative was the largest of its kind globally. The original funding from the Innovative Medicines Initiative ensured that through their public-private partnership model, the programme benefited from expertise, know-how, and resources from academia, the pharmaceutical arena and third sector. Setting the vision, managing the innovative programme and operationalising scores of crucial and interdependent elements was a substantial governance and project management undertaking. The programme is ongoing with data and samples accessible through state-of-the-art systems in partnership with the Alzheimer’s Disease Data Interoperability programme. Follow-up of research participants is being organised and their involvement in a range of clinical trials is being facilitated via collaboration with the Global Alzheimer’s Platform. The challenges and lessons learned from EPAD are important as the field continued to advance and new therapies are developed.