Enhanced recovery after surgery (ERAS) programs for spine surgery have been developed throughout Europe and the United States leading to reduced hospital stay lengths, reduced opioid consumption, and faster return to activities of daily living and exercise. Development and execution of an ERAS spine program require commitment from the physician practice and collaborative hospital along with commitments from the entire health care team. Navigating this process can be a daunting task for a surgeon, whose traditional training involves no project management. Here we review our experience in the development of an ERAS program at a major academic medical institution and tertiary-care hospital in the USA from a program management perspective. In this manuscript, we provide the language and an outline to educate a surgeon on the project management processes needed to develop and initiate a pilot spine ERAS program.