This paper reviews trends in cycling levels, safety, and policies in Canada and the USA over the past two decades. We analyze aggregate data for the two countries as well as city-specific case study data for nine large cities (Chicago, Minneapolis, Montreal, New York, Portland, San Francisco, Toronto, Vancouver, and Washington). Cycling levels have increased in both the USA and Canada, while cyclist fatalities have fallen. There is much spatial variation and socioeconomic inequality in cycling rates. The bike share of work commuters is more than twice as high in Canada as in the USA, and is higher in the western parts of both countries. Cycling is concentrated in central cities, especially near universities and in gentrified neighborhoods near the city center. Almost all the growth in cycling in the USA has been among men between 25-64 years old, while cycling rates have remained steady among women and fallen sharply for children. Cycling rates have risen much faster in the nine case study cities than in their countries as a whole, at least doubling in all the cities since 1990. They have implemented a wide range of infrastructure and programs to promote cycling and increase cycling safety: expanded and improved bike lanes and paths, traffic calming, parking, bike-transit integration, bike sharing, training programs, and promotional events. We describe the specific accomplishments of the nine case study cities, focusing on each city's innovations and lessons for other cities trying to increase cycling. Portland's comprehensive package of cycling policies has succeeded in raising cycling levels 6-fold and provides an example that other North American cities can follow. (C) 2011 Elsevier Ltd. All rights reserved.