This chapter focuses on the Swedish municipal CEO (MCEO). The development of the role over the last 25 years is analysed in terms of stability and change. The chapter discusses the changes that have taken place in terms of the demands and constraints of the role. These changes are further compared with changes in actual performance relating to the priorities of MCEOs. The results show that while contextual factors, background, and reasons for job termination have changed considerably, small or moderate changes can arguably be observed in the MCEOs’ role performance. The role of the MCEO is discussed as a stable and institutionalized role in an otherwise changing world. However, there are some minor long-term indications that the role may become either more of an extended arm of majority politicians or a professional, administrative head—or perhaps both. The findings are based on a large amount of survey data collected every five years for a quarter of a century.