The growth and consolidation of a state built around policy marked the maturation of the three distinct varieties of multilevel democracy. Over the late twentieth and early twenty-first centuries, despite pressures toward convergence, distinctions between the three types have persisted. The multilevel lens through which we have examined these national systems of local institutions and their origins casts new light on a whole range of literatures that have compared national democratic processes and policy performance among advanced industrial democracies. Comparisons of national democratic institutions, welfare states, and varieties of capitalism point to a variety of clear correspondences between national institutions, policy performance, and the overall quality of democracy. A multilevel conception of state–society relations opens a new window onto the operational realities that determine how these relationships work. Local and multilevel institutions further illuminate familiar differences among national democratic systems, and elucidate other variations in the quality of democracy that analyses of national institutions have struggled to explain. In demonstrating that local institutions were much more than an outgrowth of the main variations in national democratic traditions, we have shown how they repeatedly shaped the construction of democratic institutions at the national scale. Their consequences remain apparent in the contemporary operational realities of democracies at the local scale, and continue to influence the quality of democratic institutions today.