Since 1970, air quality management in the United States has depended in large measure on establishing effects-based National Ambient Air Quality Standards (NAAQS) that drive state and local programs to attain and maintain acceptable air quality. But what were the origins of air quality standards and management, and how did the United States come to adopt this approach for federal legislation in 1970? Why not other approaches, such as leaving air pollution control to the states or local governments, setting best technology limits as in Germany, or adopting economic incentives such as emission taxes? In addition to shedding some light on these questions, the presentation will focus on how NAAQS were established and reviewed after 1970. It shows how the NAAQS have motivated implementation programs, motor vehicle standards, regional emissions reductions, and how NAAQS-inspired research in effects, air quality, and control sciences influenced policy and legislation that improved the effectiveness of air quality management. The presentation concludes by looking toward the future of air quality management, emphasizing continuing and new challenges, particularly how to coordinate with climate change programs.