Ever since the Evolutionary Synthesis of the 1930s and 1940s, some biologists have expressed doubt that the Synthetic Theory, based principally on mutation, genetic variation, and natural selection, adequately accounts for macroevolution, or evolution above the species level. Some questions pertain to the history of biological diversity, but the greatest argument has concerned the evolution of major changes in organisms' form and function. Such changes have been the subject of debate on the nature and phenotypic effect of mutations (especially the role of "macromutations" or saltations), the role of developmental mechanisms and processes, and the importance of internal constraints on adaptive evolution. Bridging the two major macroevolutionary themes, the hypothesis of punctuated equilibria invoked constraints on phenotypic evolution and the role of speciation in both diversification and the evolution of form. This chapter describes the Evolutionary Synthesis and the challenges to it and addresses the extent to which the modern formulation of the Synthetic Theory (ST) adequately addresses the observations that have prompted skeptical challenge. I conclude that although several proposed extensions and seemingly unorthodox ideas have some merit, the observations they purport to explain can mostly be interpreted within the framework of the Synthetic Theory.