The environment in which bremsstrahlung and pair creation occurs can strongly affect cross sections for these processes. Because ultra-relativistic electromagnetic interactions involve very small longitudinal momentum transfers, the reactions occur gradually, spread over long distances. During this time, even relatively weak factors can accumulate enough to disrupt the interaction. This review will discuss a variety of factors which can suppress bremsstrahlung and pair production, as well as related effects involving beamstrahlung and QCD processes. After surveying different theoretical approaches, experimental measurements will be covered. Recent accurate measurements by the SLAC E-146 collaboration will be highlighted, along with several recent theoretical works relating to the experiment.