Align items in a stack panel?

You can achieve this with a DockPanel:

<DockPanel Width="300">
    <TextBlock>Left</TextBlock>
    <Button HorizontalAlignment="Right">Right</Button>
</DockPanel>

The difference is that a StackPanel will arrange child elements into single line (either vertical or horizontally) whereas a DockPanel defines an area where you can arrange child elements either horizontally or vertically, relative to each other (the Dock property changes the position of an element relative to other elements within the same container. Alignment properties, such as HorizontalAlignment, change the position of an element relative to its parent element).

Update

As pointed out in the comments you can also use the FlowDirection property of a StackPanel. See @D_Bester’s answer.