Twinning programs in health have gained increased recognition as a WHO preferred strategy for providing a sustainable strategy for enhancing the delivery of best practice healthcare globally. The Tonga Twinning Program (TTP), represents a longstanding relationship of some twenty-five years between The Ministry of Health in Tonga and St John of God Hospital, Ballarat, Australia and provides a compelling example of what can be achieved. This article presents the findings from a longitudinal exploration of the experiences and perceptions of the TTP through the voices of those key-stakeholders situated in Tonga who have engaged with the program. Informed by the tenets of hermeneutic phenomenology, a modified thematic analysis highlighted two major themes, ‘A shared mission' and ‘The outcomes are more than the tangibles', which supported by a series of sub-themes, identify the core components of the experience of the TTP. This study suggests that the TTP has supported a collective sense of bringing the very best available knowledge and skills to the people of Tonga and has fostered a genuine and open dialogue between partners as a mechanism for change that goes well beyond simply a capacity to replicate skills and instead has establish a genuine reciprocity akin to being a family.