The Clean Water Act influences land use patterns and land use patterns influence the implementation of the Clean Water Act. The Act’s programs have the potential to promote revitalization and development of areas with existing infrastructure. This study investigates the relationship between three Clean Water Act programs and “smart growth,” an approach to development that emphasizes greater density, mixed uses, redevelopment of underused areas, transportation choices, and open space protection. These programs can promote smart growth when federal, state, and local governments grasp opportunities to integrate water quality and smart growth goals. Some jurisdictions already have done so, resulting in efficiencies and environmental benefits. Water quality has received relatively minor consideration in most development and planning decisions compared with road construction, tax liabilities and incentives, government subsidies, land costs, and political issues. Nevertheless, the three water quality programs examined in this report have an increasing effect at the margin. The strategies and techniques for improving water quality and fostering smart growth can be mutually reinforcing.