There is a growing interest in immigrant receiving countries like Canada and the United States in spreading the benefits of immigration to less-favoured regions and cities that face a myriad of demographic and economic challenges associated with aging or shrinking populations, slow growth, and economic decline. This chapter uses the cases of Atlantic Canada and the US Rust Belt to examine two different approaches to immigration and uneven development. In Canada, place-based immigration programmes explicitly encourage immigration to Atlantic Canada while immigrant integration is supported through ‘top-down’ federally-funded settlement, multiculturalism, and citizenship programmes. Conversely, in the US, efforts to use immigration to address spatial inequality are happening outside of formal policy channels from the ‘bottom-up’, driven by networks of local business associations and non-profit organisations that increasingly promote immigration as a tool of economic revitalisation in the Rust Belt. Drawing on several years of fieldwork in both regions involving participant observation at immigration summits and conventions, stakeholder interviews, and media and document analysis, this chapter considers the implications of these diverging approaches. Ultimately, dynamic regions need dynamic solutions, and cities in these regions provide a roadmap for understanding the role of immigration in addressing uneven development.