Choosing Wisely is a global movement with dedicated campaigns in over 25 countries around the world. While early phases of these campaigns have focused on raising awareness about the importance of reducing low-value care, there is now a need to work on implementing recommendations in practice. In this BMJ Evidence Based Medicine article, Dr. Jeremy Grimshaw and Dr. Wendy Levinson share insights on actively engaging and promoting de-implementation activities and the need for a systematic approach to reducing low-value care.