The EURO Working Group on Operational Research Applied to Health Services was formed in 1975 as part of a programme for developing special interest groups within the European branch, EURO of the International Federation of Operational research Societies, IFORS. The group meets every year, each summer, for one week in a different host country, usually in Europe. Meetings are open to anyone with a quantitative background and an interest in the subject area. The objectives of the group are communication of ideas, knowledge and experience concerning the application of Operational Research (OR) approaches and methods to problems in the area of health services, mutual assistance among members, co-operation on joint projects as well as inspiration with regard to approaches and attitudes in this field. ORAHS came back to France 27 years after ORAHS’80 in Paris. Since then, French health systems have changed drastically and health care delivery engineering has attracted the interests of many academics. Many French hospitals have engaged in major re-engineering projects. The French speaking working group GISEH (Gestion et Ingenierie des SystEmes Hospitaliers) attracts over 192 members in management and engineering of healthcare systems. Since 2000, the region of Rhone-Alps has funded several major research programmes on health services engineering (HRP (2000–2003), HRP2 (2004–2006), HRP3 (2006–2009)). In Saint Etienne, the Ecole des Mines de Saint Etienne (ENSM.SE, one of the top engineering schools in France), the University of Jean Monnet (UJM) and the university hospital complex CHU-SE have created a joint research institute in health and health care. ORAHS’2007 was sponsored by EURO, ROADEF, GDR-RO, and GDR-MACS. ORAHS’2007 was supported by the following French organisations, institutions and companies: ILOG, Cluster GOSPI, Region Rhone-Aples, Conseil General de la Loire, Saint Etienne Metropole, Ville de Saint Etienne, Ministere de la recherche. ORAHS’2007 offered a scientific program including six tutorial lectures, 8 invited plenary talks, and 102 technical presentations covering various aspects of health care delivery engineering. ORAHS’2007 introduced some innovations that, we hope, contribute to make ORAHS an international conference in a domain of increasing demands. Feature sessions were organized by several national/regional working groups on management and engineering of health care systems. A “Project Ideas” section included 10 min presentations highlighting challenges of health care delivery that would benefit from joint European and international research efforts. Tutorial talks of 2 h each by six experts were organized to give young researchers and health professionals a comprehensive view of healthcare delivery engineering. This special issue contains eight papers selected from 20 submissions. The review process was handled by the three Health Care Manag Sci (2009) 12:117–118 DOI 10.1007/s10729-009-9102-2