Reducing incarceration is an important public health priority. There is now widespread recognition that criminal justice systems are a significant source of public health harm. They sometimes penalize individuals without improving community health, or create improvements that are offset by the considerable individual and communal harms associated with incarceration and with the collateral consequences of criminal convictions. Philadelphia has become a leader in implementing criminal justice reforms. In 2010, the District Attorney’s Office initiated changes to reduce overcharging. In the last seven years, the First Judicial District has created nine specialized diversion programs, with seven specifically aimed at addressing the underlying causes of criminal activity. These programs vary in design but share key features. All attempt to prevent future criminal activity by diverting offenders away from incarceration and into community supervision. Programs also provide access to appropriate social and health services, and utilize a more collaborative approach between prosecutors, defense attorneys, judges and social services staff. This more efficient use of resources allows greater attention to more serious and violent crimes in Philadelphia.