Most lobbying is invisible, meaning that interest groups routinely contact government officials “off the public record.” While such lobbying is ubiquitous, whether and how it may affect public policy decision-making remains largely unknown. I theorize that lobbying that employs both invisible and visible tactics is the most influential. I study the development of 38 health-related regulatory policies in Wisconsin to assess this argument. I employ government records, survey data from more than 350 individuals, and interviews with 15 state policymakers. I find that invisible and visible lobbying—when performed in combination—are associated with greater regulatory policy change. From a normative perspective, these results are both reassuring and troubling. On one hand, the results suggest that invisible lobbying, on its own, rarely drives state regulatory policy shifts. Yet, on the other hand, those interested parties with the resources necessary to lobby across multiple modes are more likely to see policy change.