Since the late 1970s, the US has utilized a variety of strategies to manage the problem of contaminated land and groundwater within the 50 states, a problem whose dimension is still not well defined. Recent estimates indicate that the US may spend up to 1 trillion dollars over the next 20 to 30 years undoing the environmental damage caused by improper storage and disposal of hazardous materials and toxic wastes over the past several decades, but predominantly since the end of World War II. Whether these expenditures will provide an equivalent level of benefit or risk reduction to US citizens is a subject of current debate. The effective management and remediation of this complex array of sites is proving both difficult and expensive. Research over the past decade has shown that in many cases, technology is limited in its ability to restore contaminated sites to pre-industrial conditions. In the US, new policy initiatives are being developed that insure both protection of human health and the environment, but at significant reduction in life cycle costs to society. Risk-based decision making is replacing rigid politically driven remediation decisions. The changes in the US model for management of contaminated sites provides valuable insights to other nations who are or will be faced with the same difficult choices balancing the costs of remedial strategies against potential reduction in risks to human health and the environment.