Despite the widespread use of value chain development (VCD) approaches to poverty reduction, there has been limited debate on how VCD is implemented in the field, from the approaches, methods, and tools used, to the investments and partnerships made. The article presents five case studies: tea, dairy, horticulture, cinnamon, and fish in Vietnam. For each case, we conducted interviews with development agencies, producer organizations, and principal buyers. The cases examined how VCD interventions were designed, the role of different stakeholders in the implementation process, and the challenges faced by practitioners and chain actors to achieve impact at scale. Results suggest that VCD interventions tended to focus on supporting smallholder participation in high-value, fast-growing markets, but based on a narrow set of activities, mainly around upgrading smallholder production capacities and establishing producer associations. Overall, collaboration with downstream buyers and service providers was muted and, in a few cases, non-existent. Opportunities for increased impact exist based on increased collaboration between practitioners and researchers to employ VCD tools in specific contexts, as well as to design new tools for addressing specific needs and facilitate joint learning on the implementation process and related outcomes. The findings also suggest a need for dedicated approaches to supporting producer organizations, given their central role in the implementation of VCD interventions.