Scientific advances can be smart, tantalizing, bizarre— and still never make it out of the lab. To change the world, a new idea must have a path from drawing board to practical products and manufacturing processes: in the parlance of Silicon Valley, it must “scale.” Nobody can predict the future, but each of the 10 breakthroughs on the following pages has the potential to make it big. We begin with a full-length article on a new way to design materials atom by atom, using supercomputers and the equations of quantum mechanics, which could take much of the perspiration out of innovation. We continue with a fast-paced look at “metamaterials” that promise cell phones as thin as credit cards; genomic therapies that turn ordinary gut microbes into weapons against disease; planes and bridges made of ultralight pieces that snap together like Legos; an antiseptic that could prevent 500,000 infant deaths a year; and other good ideas. Look for them in the years ahead.