The ongoing transition to low fertility is, alongside the long-term expansion of life expectancy, the key force reshaping populations around the world. It has sweeping economic and social repercussions as it affects labour markets, intergenerational ties, gender relations, and public policies. Many middle-income countries, including China, Brazil, Iran, and Turkey, have joined the expanding list of low fertility countries. Consequently, low fertility is no longer an exclusive feature of rich Western societies. As close to half of the global population now lives in regions with below replacement fertility, low fertility has become a truly global phenomenon. What are the key ingredients of this ‘revolutionary’ change? Expanding education, rising income, the rise of gender equality, female labour force participation, ideational changes, consumerism, urbanization, family disintegration, economic uncertainty, globalization, modern contraception, and many other complementary or contrasting forces are often highlighted. But how will these drivers shape the long-term future of fertility? Will fertility in most countries stabilize at around the replacement level threshold, as implied by the demographic transition theory, or will it decline below this level? Is very low fertility merely a ‘passing phenomenon’, a sign of a temporary imbalance between rapid social and economic changes and opportunities on the one hand, and family, gender relations, and reproduction on the other? This chapter aims to present both a comprehensive overview of the forces shaping contemporary reproductive behaviour in low fertility countries and an exploration of possible future scenarios based upon a new IIASA–Oxford survey of international experts introduced in Chapter 2 of this volume. We begin with a presentation of recent trends in fertility in low fertility settings followed by a review of the particular recent histories of fertility change in North America, Europe, and the emerging low fertility settings in East Asia, Latin America, and the Middle East. We then explore the theoretical and empirical evidence that has been cited in the literature as underpinning these past trends and possible future scenarios. As well as ‘meta-theories’ such as the Second Demographic Transition (SDT), section 3.2 considers the roles played by cultural, biomedical, and economic factors, family policies, economic uncertainty, education, and the contribution of migrants’ fertility.