In this chapter of Foster Care and Best Interests of the Child, we describe the history of legislative and judicial efforts to reform the foster care system. At the federal level, we focus on the policies present for the past 40 years and evaluation of state foster care systems through the federal Child and Family Services Reviews. We identify federal policy reform efforts that highlight a substantial focus on limiting the size of the foster population through reduced entries or shorter lengths of stay and supports for youth aging out of care. There have been fewer efforts to improve the quality of foster care parents or homes or to track the experiences and well-being of children within the foster care system. We also discuss the role of class-action litigation against state and local child welfare systems on behalf of children in foster care. In our detailed review of active litigation and settlements on behalf of children in foster care, we have shown that many of the lawsuits highlight deficiencies in resources, such as adequate supplies of qualified staff and foster homes, as key areas for reform. We then assess the possibilities and limitations of litigation for achieving meaningful system reform.