Highly skilled immigrants to the United States (HSIs), particularly those with graduate degrees in science, engineering, technology, and math (STEM) fields, have helped catalyze innovation, economic growth, jobs, wealth, and advances in human welfare. America has been attractive to HSIs and other innovators at least in part because of its fundamental freedoms, market-friendly values, and reliable infrastructure. But this past success provides no assurances for our future. Consider three questions. First, could our nation have achieved substantially more if our policy had focused more deliberately on HSIs’ potential economic contributions? Second, how can the United States ensure that we continue to benefit from HSIs in the face of increased competition from other countries seeking to attract (or retain) them? And finally, is our economic leadership being compromised by clinging to old policies not well adapted to current and future circumstances? In this chapter, we marshal data and evidence demonstrating that HSIs spur innovation and entrepreneurship, particularly in STEM fields. We also show that new approaches could better deploy these talents and increase economic growth. Among changes that we advocate are allowing state and local governments to target their efforts to recruit and arrange for permanent or at least provisional visas to HSIs; guaranteeing such visas to HSIs who receive degrees, particularly at the graduate level, from U.S. universities in STEM disciplines; and adopting a new system that uses points, an auction, and/or job creation potential to direct visas to HSIs who can advance innovation, entrepreneurship, and economic growth