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This issue of Clinics in Laboratory Medicine, guest edited by James E. Kirby, will focus on Advances and Trends in Clinical Microbiology and take a look at the next 20 years. Topics include, but are not limited to, Rapid susceptibility testing methods; Synergy testing; Serology testing re-imagined; Total Laboratory Automation in Clinical Microbiology; MALDI-TOF; Superbugs of the Future, the Antimicrobial Laboratory Resistance Network, Partnerships between Public Health and the clinical microbiology laboratory; Next generation sequencing, from identification to susceptibility prediction; Distributed microbiology testing; Direct from Sample Identification; Biomarkers - predicting viral versus bacterial infection; PK/PD in the era of emerging multidrug-resistance; Training the next generation of clinical microbiologists; and Pictorial illustration of debate, developments, and controversy in clinical microbiology.