The aim of this paper is to describe and understand the evolution of the care farming sector in one of its pioneering countries, the Netherlands. Care farms combine agricultural production with health and social services. Care farming is a phenomenon that faces specific challenges associated with connecting two different domains. Organizational ecology, social movement theory and the multi-level perspective are helpful concepts in interpreting and contextualizing the developments that have taken place. Organizational ecology explains how the number of care farms, and the legitimacy and diversity of the care farming sector, have increased rapidly over time. Strategic actions of dedicated boundary spanners have played an important role in the development of the sector. Social movement theory explains the impact of collaborative action in the pioneering and later stages. The multi-level perspective explains changes in the care regime, like the introduction of the personal budget of patients and the liberalization of the Dutch health care sector, helping to provide access of foundations of care farms to the collective health insurance for the costs of long-term care. Media exposure, contacts with ministries and politicians and the development of a quality system have contributed to the legitimacy of the sector. Changes in the care regime and collective action promoted a further expansion of the sector and provided direction to the ways the sector developed qualitatively, especially in terms of the emergence of structures aimed at facilitating existing and promoting new care farming practices. Our framework sheds light on changes in agriculture and transsectoral collaboration.