The chapter presents a comprehensive and thorough review of the Brazilian Health Care System, the SUS, covering its historical, conceptual, and practical aspects. Readers will gain an in-depth understanding of the system's main components and challenges, from its inception to its current state. The mechanisms for governance and coordination, health financing, and health care delivery policies are described in detail, alongside an honest portrayal of the pervasive inequalities that plague the country, challenging SUS’s promise of universal access. Additionally, the chapter outlines the national response to the COVID-19 pandemic. In conclusion, it offers a critical reflection on the inherent contradictions of the SUS and proposes actionable solutions for health managers to orchestrate the various interests within the system in a more coordinated and favorable way. By mobilizing strategies of scale, coordination, and incentive, these flaws can be tackled in the short term, resulting in a more equitable and efficient health care system for all.