Every day over 50,000 Canadians use specialized transit for their travel needs. The approach to delivering specialized or paratransit transit service across Canada varies greatly. Service providers frequently seek information regarding approaches to various aspects of service design and delivery. The primary objective of this research is to provide a framework for improving nationwide specialized transit operations by identifying the top 15 operational areas of significance. Peer practices are documented to assist Canadian agencies in allocating their efforts and informing decisions across an array of operational topics. Due to the variances in how service is operated from agency to agency, a comprehensive approach was used to determine practices and topics applicable to all specialized transit agencies.