The type of institutional arrangementfor managing roads adopted by a country depends on theobjectives and performance that it sets for its roadnetworks. This paper reviews such arrangements for selectedcountries; China, Brazil, Slovenia, New Zealand, UnitedKingdom, and the Slovak Republic. These countries haveadopted different approaches in several dimensions, such asdecentralization, sources of financing, managementstructure, and modal responsibility. This paper reviews mainfactors affecting the efficiency of road agencies anddescribes the steps taken in creating a new institution, ortransforming an existing one, and assesses the effortrequired to achieve such results. In all countries reviewed,the ministry responsible for the transport sector remainsthe authority responsible for the overall transport policyand for putting in place checks and balances for goodgovernance and management of fiscal risk. The main aspectsof institutional reforms that can contribute to increase theefficiency of road and transport agencies include: improvedinstitutional structures, separation of the client andsupplier functions, separation of client and supplierorganizations, privatization of the supplier organizations,establishment of an executive agency or a commercialized(client) organization, user participation through oversightboards, improving management information systems, andseeking additional sources of financing.