The widespread prevalence of economically, socially, and environmentally unsustainable practices in global value chains is a pressing international challenge. The way to improve systems and practices in the complex networks that characterize contemporary production processes is not clear cut. Finding solutions requires innovation. This Element examines the structures of garment value chains and explores how innovation related to sustainability is taking place in these chains. Furthermore, it identifies barriers and opportunities for innovations to break through and stimulate industry-wide change.