The Civil War-era U.S. Sanitary Commission (USSC) was the largest wartime benevolent institution. Judith Ann Giesberg demonstrates convincingly that that generation of women provided a crucial link between the local evangelical crusades of the early nineteenth century and the sweeping national reform and suffrage movements of the postwar period. Drawing on Sanitary Commission documents and memoirs, the author details how northern elite and middle-class women's experiences in and influence over the USSC formed the impetus for later reform efforts. Giesberg explores the ways in which women honed organizational and administrative skills, developed new strategies that combined strong centralized leadership with regional grassroots autonomy, and created a sisterhood that reached across class lines. She begins her study with an examination of the Woman's Central Association of Relief, an organization that gave birth to the USSC. Giesberg then discusses the significant roles of Dr. Elizabeth Blackwell, Dorothea Lynde Dix, and Henry Whitney Bellows, and considers the rationale for bringing women and men together in a collaborative wartime relief program. She shows how Louisa Lee Schuyler, Abigail Williams May, and other young women maneuvered and challenged the male-run Commission as they built an effective national network for giving critical support to soldiers on the battlefield and their families on the home front. This fresh perspective on the evolution of women's political culture fills an important gap in the literature, and it will appeal to historians, women's studies scholars, and Civil War buffs alike.