Organizing medical research in an outreach setting can be a challenging task, especially when it involves complex spine procedures in patients whom it is difficult to follow-up for long term. Disease severity at presentation is often advanced in outreach settings due to limited local resources, surgeon expertise, and hospital infrastructure. Case complexity can present a challenge to local and outreach surgeons alike. This article will describe what encompasses an ideal outreach program as it relates to spine, how to manage cost in an outreach setting, collection of outcome data, and maintaining long-term follow-up. As one of the criticisms of medical outreach is the relative paucity of outcome data, this article discusses methods to collect and report outcomes abroad. We also discuss the value of translating outcome questionnaires to different languages and cross-cultural comparisons. In addition, relatively rare pathologies are often seen with greater frequency abroad. These patients are ideally suited for a focused case series than can guide treatment decisions.