For a very long time, Albania has had one of the highest levels of fertility in Europe: in 2002 the total fertility rate of 2.2 children per woman was the highest in Europe. Although this current level is high, the country has experienced a rapid fertility reduction during the last 50 years: a TFR decline from 7 to 2.2. This reduction has occurred in the absence of modern contraception and abortion, which indicates the significance of investments in the social agenda during the communist regime that produced policies with indirect effects on fertility. Most significant of these were policies focused on education, in particular on female education. Social and demographic settings for a further fertility reduction in Albania have been present since 1990. Contraception and abortion have been legalized and available since the early 1990s, but knowledge of their use is still not widespread in the country, largely due to the interplay between traditional and modern norms of Albanian society. This chapter points out that future fertility levels will be determined not only by new policies that might be introduced, but predominantly by the balance of this interplay.