The overuse and misuse of antimicrobial agents has detrimental effects on patients, the health care system, and society. Inappropriate antimicrobial use contributes to the rising cost of health care, the emergence of multidrug resistant organisms, and adverse drug reactions. Antimicrobial stewardship programs provide standard, evidence-based approaches to encourage judicious use of antimicrobial agents. This review summarizes the goals of antimicrobial stewardship programs, the members needed to initiate and sustain them, antimicrobial stewardship strategies, barriers to the implementation and maintenance of the programs, approaches to measure their effects, and the basic steps needed to initiate them.