Aims: The aim of this paper is to offer an account of the history and current status of gambling research in the United States. Methods: A review of the literature. Results: Gambling has been a part of society in the United States since its early history. However, it was not until 1980 that the medical profession in the United States first recognized pathological gambling as a psychiatric disorder. Today, it is still rarely diagnosed or treated, and relatively little federal funding is available to support research in this area.With the upcoming fifth revision of the Diagnostic and Statistical Manual of Mental Disorders, pathological gambling is likely to be included alongside substance use disorders as the first non-substance-related addictive disorder. This change may represent an opportunity to expand research on gambling and treatment of pathological gambling. Conclusions: We provide 10 suggestions for reducing societal and personal harm associated with this disorder.