Trade in live plants has been recognized worldwide as an important invasion pathway for non-native plant pests. Such pests can have severe economic and ecological consequences. Nearly 70% of damaging forest insects and pathogens established in the US between 1860 and 2006 most likely entered on imported live plants. The current regulation of plant imports is outdated and needs to balance the impacts of pest damage, the expense of mitigation efforts, and the benefits of live plant importation. To inform these discussions, we document large increases in the volume and value of plant imports over the past five decades and explain recent and proposed changes to plant import regulations. Two data sources were used to estimate the infestation rate of regulated pests in live plant shipments entering the US, thus allowing evaluation of the efficacy of the current port inspection process.