Do you actually need publications for an NIW?

Short answer, no. Publications and citations help in research-heavy fields, but the NIW is not limited to academics. Founders, engineers, clinicians, and business professionals qualify with evidence like adoption of their work, revenue or jobs created, letters from independent experts, patents, media, and measurable outcomes. The question is whether your evidence proves you are well positioned and that your work matters nationally, not whether you have a citation count. What evidence is strongest in your file?