This article describes and analyzes the territorial organizational approach in the context of sustainable development (ATDD) elaborated in the Lanaudière region since the early 2000s. We present the approach first by contextualizing it and describing its main features. We situate this approach in the broader context of such practices in community development and bring out some major challenges and opportunities for intervention and research. Finally, we make some explanatory hypotheses about the challenges for the sustainability of such an approach.