Linkage to care is a crucial early step in successful HIV treatment and is typically defined as the completion of a first medical clinic visit after an HIV diagnosis. Linkage to care plays a crucial role in the HIV care continuum because it is a necessary precursor to retention in care, antiretroviral therapy initiation, and viral suppression. Evidence clearly demonstrates that antiretroviral treatment significantly reduces the risk of developing HIV-related complications and the risk of death. In addition, antiretroviral therapy dramatically reduces HIV transmission to others.Without timely entry into care, individuals with HIV infection miss an opportunity to benefit from HIV treatment at the earliest stage feasible; linkage to care within 3 months significantly increases the likelihood of achieving viral suppression. Delayed linkage to care also is a major barrier to the potential for “treatment as prevention” to reduce HIV transmission rates in the United States. Thus, identifying persons with HIV infection and successfully linking them to care plays a critical role in the overall HIV epidemic, both from a treatment and a prevention standpoint. This following provides a review of the current state of linkage to care in the United States, examines barriers to linkage to care, and explores future opportunities for improving engagement in care.