SYMMACS, the Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-up, is the first systematic assessment of quality of services, surgical efficiencies, provider performance, and related aspects of VMMC service delivery in four countries: Kenya, South Africa, Tanzania, and Zimbabwe. This multicountry cross-sectional study, conducted in both 2011 and 2012, has identified strengths of these programs and areas for improvement, which have informed programming in all four countries. The report is also available on the Research to Prevention website.