Exploring and understanding the nature and evolution of primordial fluctuations is an essential component of modern cosmology. The form of the perturbation power spectrum contains information about the very early Universe and also controls key aspects of the large-scale structure of the distribution of matter at the present epoch. In this talk I will discuss methods for precision determination of the power spectrum from inflation, including inverse techniques that directly link measurements to the inflationary equation of state. I will also explain how the quasar Ly-alpha forest can be used to measure the primordial fluctuation power spectrum and give a status report on our present work in extracting this information from the Sloan Digital Sky Survey.