This final chapter draws conclusions from the 32 preceding chapters, written by a diverse range of health technology assessment (HTA) stakeholders, to outline key concepts, methods and approaches for effective patient involvement in HTA. Since the first edition of this book, the use of HTA around the world has expanded alongside growing recognition of the importance of social participation in healthcare. As a result, the adoption of patient involvement practices—shaped by various HTA contexts—has gained momentum. With growing investment in training and resources to improve its effectiveness and with increasing experience, patients now contribute to HTA not only through consultation but also through co-design, co-production, and inclusion in decision making and governance. Despite progress, remaining barriers include resource constraints, competing priorities, staff turnover, leadership attitudes, and broader policy trends. Specifically, this chapter highlights key areas where many HTA systems could benefit from greater focus and investment: implementing patient involvement beyond individual HTAs, utilising developers research on patient aspects and strengthening such research, broadening participation, building capacity and knowledge of good practice and methods, setting shared goals and evaluating, and giving feedback to the participating patients. Addressing these areas will advance meaningful and sustained patient involvement in HTA worldwide.