The development and commercialization of transgenic plants expressing insecticidal toxin genes from the bacterium Bacillus thuringiensis (Bt) has revolutionized agriculture in the past two decades. Development of this revolutionary insect pest control technology was facilitated by the identification and characterization of insecticidal Bt proteins and advancements in plant transformation and genetic engineering. While commercialization of this technology is currently limited to a number of countries, these transgenic "Bt crops" are replacing in most cases conventional crop varieties due to their insect resistance, lower spraying requirements, and higher yields. However, concerns related to the increasing adoption of this technology include gene flow to wild relatives, evolution of resistance in target pests, and unintended effects on the environment. In this chapter, we discuss key events in the history of Bt crop development and summarize current regulations aimed at reducing the risks associated with increased adoption of this technology. By analyzing the history of Bt transgenic crops and the current marketplace trends and issues, we aim to examine the outlook of current and impending Bt crops as well as potential issues that may emerge during their future use.