This article addresses questions of institutional anchoring, coordination and participatory approaches with a comparative, case-based examination of regional development practices in selected large-scale infrastructure projects. It draws on four case studies – the expansion of Frankfurt Airport, the decommissioning of the Asse II mine in Germany, the Swiss sectoral plan procedure for deep geological repositories, and the Swedish repository siting process – as exemplary constellations of how regional development is institutionally and procedurally designed in practice. The case studies are used to abstract typical instruments, actor constellations, and modes of interaction between formal planning, participation, and informal regional development approaches. Based on a cross-case synthesis, the article identifies recurring challenges and patterns of success.