This paper describes how the COPASAH Global Symposium treated the Theme of ‘Community Action in Governance and Accountability for Health System Strengthening’. We first lay out COPASAH’s understanding of Social Accountability in health systems as centre-staging the transformative potential of the power of the communities rather than seeing social accountability as merely a tokenistic participation of the community. Through case studies presented by practitioners from across the globe, the Theme positioned communities and civil society at large as central to the governance and accountability of health systems (both public and private). The important role of contextual analysis in defining the strategies and interventions for demanding accountability was discussed. Participants’ experiences of demanding accountability brought out clearly the importance of linkages from the local action to global mobilisation. Further, the discussions reaffirmed COPASAH’s principles of Social Accountability in Health that informed COPASAH Charter and Call to Action for Social Accountability for Health.