Concern about how American elections work has risen since 2000 and has been exacerbated by events during the 2016 campaign. To understand these issues, the first section examines several major challenges facing U.S. elections, including deepening party polarization over electoral procedures, the vulnerability of electronic records to hacking, and the impact of deregulating campaign spending, compounding the lack of professional standards of electoral management. For a broader perspective, section 2 clarifies the core concept and measure of 'electoral integrity', the key yardstick used in this report to evaluate the performance of American contests. Section 3 compares cross-national evidence from expert surveys, finding that recent US elections have the worst performance among two-dozen Western democracies. Section 4 considers pragmatic reforms designed to strengthen U.S. electoral laws and procedures, recommending expanding secure and convenient registration and balloting facilities, improving the independence and professional standards of electoral management, monitoring performance, and strengthening impartial dispute resolution mechanisms. The conclusion summarizes the core argument and the reforms.