The American Fisheries Society (AFS) herein provides a list of all native freshwater mussels (families Margaritiferidae and Unionidae) in the United States and Canada. This report also provides state and provincial distributions; a comprehensive review of the conservation status of all taxa; and references on biology, conservation, and distribution of freshwater mussels. The list includes 297 native freshwater mussels, of which 213 taxa (71.7%) are considered endangered, threatened, or of special concern. Twenty-one taxa (7.1%) are listed as endangered but possibly extinct, 77 (20.6%) as endangered but extant, 43 (14.5%) as threatened, 72 (24.2%) as of special concern, 14 (4.7%) as undetermined, and only 70 (23.6%) as currently stable. The primary reasons for the decline of freshwater mussels are habitat destruction from dams, channel modification, siltation, and the introduction of nonindigenous mollusks. The high numbers of imperiled freshwater mussels in the United States and Canada, which harbor the most diverse fauna in the world, portend a trajectory toward an extinction crisis that, if unchecked, will severely impoverish one of our richest components of aquatic biodiversity.