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This chapter considers scenarios for the development of the Russian economy in the medium term under the “new reality” conditions, with the latter implying a slowdown in China’s economic growth rate, lower commodity prices, rising geopolitical tensions, and the rapid development of digital technologies leading to the fourth scientific and technological revolution. The results of scenario calculations show that the implementation of the economic growth target scenario requires targeted efforts to increase human capital, increase investment in fixed assets and innovation, export diversification, and achieve perfection in the quality of political and economic institutions. Sustainable growth of 3% per year in the medium term is possible only with the restructuring of the economy; otherwise, even with favorable conditions in the commodity markets and higher efficiency of the existing economic system, it is impossible to achieve high rates of economic growth necessary to significantly improve the quality of life.