The United States, the world’s largest economy, has made progress in reducing several environmental pressures while maintaining one of the highest Gross Domestic Products per capita in the world. It has decoupled emissions of greenhouse gases, air pollutants, water abstractions and domestic material consumption from economic and population growth. However, high consumption levels, intensive agricultural practices, climate change and urban sprawl continue to put pressure on the natural environment. Despite the recent acceleration of action to address climate change, further efforts are needed to achieve the goal of net-zero greenhouse gas emissions by 2050. The United States is also among the major contributors to marine litter with serious consequences for communities and the environment. The review provides 30 recommendations to help the United States improve its environmental performance, with a special focus on marine litter and a cross-cutting focus on environmental justice. This is the third Environmental Performance Review of the United States. It provides an independent, evidence-based evaluation of the country’s environmental performance over the past decade.