In recent years, LAST-m (AgPb m SbTe m+2) and related materials have emerged as potential high performance high temperature thermoelectrics. One example is LAST-18. When optimally doped, this compound has thermoelectric figure of merit ZT=1.7 at 700K. This large ZT is most likely due to the low lattice thermal conductivity, caused by phonon scattering from nanostructures. These nanostructures involve clustering and ordering of Ag, Sb, and Pb ions. The origin of these nanostructures has been studied using Monte Carlo (MC) simulation of an ionic model and ab initio studies of pair interaction energies. Effects of these substitutions on the band structure near the gap and their implications on transport properties are briefly discussed.