Publisher Summary This chapter describes the coal-fired emissions and legislative action in the United States. This chapter illustrates the use of coal has a long history of emitting a variety of pollutants into the atmosphere and has contributed to several known health episodes in the past. In the United States, the major development of legislative and regulatory acts occurred from 1955 to 1970, and by the mid- 1970s the basis for national regulation of air pollution was well developed. The regulations are continually changing, as more information on the effect of emissions on health and the environment is obtained, new control technologies are developed, and society demands a safe living environment. The use of coal for power generation is a highly regulated industry with more regulations soon to be implemented. This chapter explains the past health episodes, primarily in light of their role in the passage of regulations on the use of coal. The emphasis of this chapter is on federal legislation and regulatory trends in the United States. A history of legislative action in the United States as it pertains to coal-fired power plants is presented, and it also discusses the impending legislation regarding emissions not currently regulated. This chapter concludes with a brief discussion of emissions and legislation from other countries and the purpose of comparing to the United States.