Heralding a “new chapter of American greatness, the president said: “The time for small thinking is over.”
He still employed dark language to describe the threat posed by “radical Islamic terrorism” - a term his own national security adviser rejects as inflammatory - and warned against “reckless” and “uncontrolled entry” of refugees and immigrants from countries with ties to extremist groups.
Mr Trump’s overall message on immigration, one of his signature campaign issues, was unexpectedly mixed.
He said “real and positive immigration reform is possible” and had suggested to news anchors earlier that he was open to legislation that could provide a pathway to legal status for some of the millions of people living in the US illegally.
In his hour-long address, Mr Trump defended his early actions in office and ignored the missteps that have set even his allies in Washington on edge.
He was unusually measured and embraced the pomp and tradition of a presidential address to Congress as he outlined a populist agenda centred on promises to compel companies to bring manufacturing jobs back to the US.
The president was greeted by enthusiastic applause as he entered the House chamber.
Most Republican legislators have rallied around him since the election, hopeful that he will act on the domestic priorities they saw blocked during Barack Obama’s eight years in office.
Topping that list is undoing Mr Obama’s signature health care law.
Mr Trump offered a basic blueprint of his priorities, including ensuring that those with pre-existing conditions have access to coverage, allowing people to buy insurance across state lines and offering tax credits and expanded health savings accounts to help Americans purchase coverage.
He suggested he would get rid of the requirement that all Americans carry insurance coverage, saying that “mandating every American to buy government-approved health insurance was never the right solution for America”.
Making a direct appeal for bipartisanship, he turned to Democrats and said: “Why not join forces to finally get the job done and get it done right?”
Democrats sat silently while Republicans stood and cheered.
Delivering the Democrats’ formal response after the speech, former Kentucky governor Steve Beshear accused Mr Trump of planning to “rip affordable health insurance” from Americans and being “Wall Street’s champion”.
The president was vague in his call for tax reform, another Republican priority.
He promised “massive tax relief for the middle class” and a reduction in corporate tax rates, but glossed over how he would offset the cuts.
The president also urged Congress to pass a trillion-dollar (£800 billion) infrastructure package financed through public and private capital.
“The time has come for a new programme of national rebuilding,” he said.
First lady Melania Trump sat with special guests on hand to amplify the president’s agenda, including the family members of people killed by immigrants living in the US illegally.
The widow of former Supreme Court Justice Antonin Scalia also sat alongside Mrs Trump, a reminder of the president’s well-received nomination of federal appeals court Judge Neil Gorsuch to fill Judge Scalia’s seat.
The majority of Mr Trump’s address centred on the domestic, economic-focused issues at the centre of his presidential campaign.
His national security message centred largely on a call for significantly boosting military spending and taking strong but unspecified measures to protect the nation from “radical Islamic terrorism”.