Since 1981 three American cities—Boston, San Francisco, and Santa Monica—have adopted downtown planning policies that link large-scale commercial development with housing, transit, and employment to mitigate the negative effects of downtown growth. In this article I review the experience of those cities. I also discuss issues raised in debates about linkage policies in other cities and the factors that are critical to adoption of such policies; identify policy issues in the design and implementation of linkage programs; discuss the legality and effects of linkage policies; and analyze two alternatives to linkage policies. I conclude that only a few cities are likely to adopt linkage policies; that linkage programs are likely to have a significant but only marginal effect on social problems aggravated by downtown growth; that the effects and legality of linkage are unresolved; that linkage policies should be tied to comprehensive downtown plans; and that such policies can provide an equitable means of redistributing the social costs of downtown development.