 The Clinical and Translational Science Award, CTSA, Pilot Projects program at the University of Texas Health Science Center at San Antonio, UTHSCSA, has been using Lean Six Sigma methodologies to streamline its review process for grant applications. The CTSA team surveyed applicants and reviewers to identify areas where delays occurred and then implemented a study section style review mechanism. This resulted in a reduction of two months in the time it takes to award grants and increased satisfaction among all stakeholders. This article was authored by Suzanne Schmidt, Laura Aubry-Shea, Consagin, and others.