A confluence of external forces has driven market consolidation in ophthalmology. Consolidation activity includes smaller practices joining forces to share expenses and better position themselves for the future, retiring physicians selling to larger practices, and private equity-backed management companies buying practices and surgery centers. Regardless of the reasons for merging, administrators and owners need to prepare their practices to ensure a smooth transition. Integration can be time-consuming and costly, but we contend it is even more expensive to separate practices if the integration is unsuccessful. Proper preparation to combine practices is paramount to success, as it saves time, aggravation, and money. This article provides four key steps to ensure a successful integration.