This paper reviews the salient features of natural family planning (NFP) and how it is provided. It also reviews the issues that influence how NFP is mainstreamed including client needs, provider expectations and capabilities, service delivery strategies and policy questions. Ways providers could make NFP easier for clients to learn include incorporating fertility awareness in all family planning client education efforts, teaching NFP in groups, and using a competency-based approach to teach NFP. The question of whether NFP teachers need to be users is analyzed from historical and current perspectives, and four options are presented for organizing NFP services in multi-method settings. Finally, the policy issues that multi-method providers will need to address when NFP is incorporated into their choice of methods are discussed.