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Municipalities employ cooperation strategies to build instruments for economic and administrative rationalization and overcome difficulties in public service execution. One of these instruments is inter-municipal public consortia, which simultaneously cover multiple areas of activity. The health sector has the most consortia and participation from municipalities. The Intermunicipal Health Consortium of the Northwest of Rio Grande do Sul (CISA) is one of these consortia; it was established in 1997 and covers 47 municipalities in the northwestern region of the state. CISA establishes agreements with doctors and clinics for consultations and specialized tests and procures medicines for associated and partnered municipalities. Given this context, this article analyzes the relevance of Public Health Consortia for municipalities, particularly small ones. The study uses quantitative methods, such as analyzing reports from CISA and municipalities (Augusto Pestana, Bozano, and Panambi in Rio Grande do Sul), and qualitative methods based on interviews with Municipal Health Secretaries and Consortium managers. The data obtained, both from CISA and the Municipal Health Departments, show the importance of the consortium for the municipalities and the significant values involved in the eight years of training, as well as the fact that it constitutes the alternative with the greatest feasibility in overcoming demands and difficulties, especially in small municipalities. [ABSTRACT FROM AUTHOR]