The future of impact assessment has to contend with global megatrends, including the Fourth Industrial Revolution, that are set to change the face of the planet, and with the neoliberal economy, and the implications this has for trade-offs in decision-making under the umbrella of ‘sustainable development’. Together these challenges have implications for human health and well-being, and biodiversity. In this letter, we set out these challenges, before moving onto the solutions that are needed to rise to them. These include: formalising technology assessment processes and/or the inclusion of emerging technologies within the scope of legislated IA processes; a move towards legislated substantive outcomes, rather than enforcement of procedure only; and ensuring that the framing of IA goals are based on societal definitions of sustainability.