Quantum photonic platforms have proven to be essential in realizing fundamentally secure quantum transfer of information, with commercially ready systems already deployed in municipal and terrestrial links. The drive toward higher bit rates and robustness to eavesdropping and noisy channels has focused attention on moving from the present two-dimensional quantum states of polarization, to harnessing all of light's degrees of freedom for multi-dimensional quantum coding with structured photons. In this Perspective, we outline the present state-of-the-art in achieving this control with spatial modes of light, both as single photon and entangled states, highlight the open challenges that remain, and consider the roadmap that might see its full potential realized.