Despite the increasing use of electronic payments, currency retains an important role in the payment system of every country. In this article, the authors compare and contrast trade-offs among currency design features, including those primarily intended to deter counterfeiting and those to improve usability by the visually impaired. The authors conclude that periodic changes in the design of currency are an important aspect of counterfeit deterrence and that currency designers worldwide generally have been successful in efforts to deter counterfeiting. At the same time, currency designers have sought to be sensitive to the needs of the visually impaired. Although trade-offs among goals sometimes have forced compromises, new technologies promise banknotes that are both more difficult to counterfeit and more accessible to the visually impaired. Among the world’s currencies, U.S. banknotes are the notes most widely used outside their country of issue and thus require special consideration.