Nearly two decades into the 21st century, we revisit the topic of changes in the US agricultural system. We focus on trends in structure, technology and policy, and on the increasing influence of consumer preferences on this system, particularly for organic agriculture and local and regional foods. We examine technological innovations in the 21st century, including biotechnology, precision agriculture and indoor farming. Within overall trends toward consolidation, we identify an increasing number of vegetable farms and greenhouse operations, accompanied by a decrease in average size of those operations. We note the shift away from price support toward greater reliance on risk management in farm policy, and also track the impact of food movement trends on recent farm bills. While farm bill policies continue to focus on conventional field crop agriculture, some trends—expanded crop insurance, conservation program support and spending on federal data collection, research and community-based grants, for example—have begun to incorporate the growing movement toward organic, local and regional food systems into the mainstream of US agricultural production and policy.