Buprenorphine is a new FDA-approved medication for treating opioid dependence. There has been little described about the practical aspects of setting up such a practice or clinic. This article describes the practical aspects of using buprenorphine in an outpatient setting based on the one-year experience of a clinic which is housed within a busy outpatient substance abuse clinic in a Veterans Hospital setting. The spectrum of treatment from induction to maintenance and stabilization and, when appropriate, discharge as well as other treatment challenges is discussed. Overall both patients and staff report a positive experience. The purpose of describing this process is to encourage those practitioners that are considering starting buprenorphine clinics to do so. This in turn will make this pharmacotherapeutic option for patients with opioid addiction more widely available.