Context-Four challenge campaigns in 2012 and 2013 were undertaken to promote organ donor registrations in New York State. Challenge campaigns relied on community advocates statewide to initiate month-long outreach efforts with top teams earning monetary rewards and public recognition. Objective-To significantly increase the number and proportion of New York residents who have consented to donation through the electronic registry. Design-Four month-long campaigns undertaken in fall and spring of 2012 and 2013. Setting-Statewide recruitment efforts organized by New York Alliance for Donation and the 4 organ procurement organizations in New York State. Participants-Adult residents of New York State. Intervention-Project staff recruited team leaders across New York State and used online and offline resources to recruit teams, educate team leaders, and bolster outreach efforts. Main Outcome Measures-Number of completed registration forms within month-long campaign periods. Also investigated were statistics on website use (eg, page views, new visitors) and interviews with team leaders regarding campaign activities after the campaign. Results-Across 4 campaigns, 107 teams were recruited and 2286 persons registered their consent to donate through the state system. Each team recruited a mean of 21 persons; 40% of teams registered 0 persons. (C) 2015 NATCO, The Organization for Transplant Professionals