Accountability and student achievement have posed major challenges to U.S. accreditation for the last decade. The responses to these challenges have been shaped not only by the origins, values and structure of accreditation, but also by the fundamental features of U.S. higher education with its history of decentralization, diversity and complexity. This paper offers brief profiles of U.S. higher education and accreditation as well as describing their complicated relationships with the federal government. The profiles provide the context for consideration of how U.S. accreditation has addressed both accountability and attention to student achievement, meeting these challenges within the framework of its longstanding values, processes and practices.