The CDC reported 338 confirmed measles cases in the U.S. from January 1, 2020, to March 28, 2024. Of these, 97 (29%) occurred in the first quarter of 2024, a seventeenfold increase over the average of five cases per quarter from 2020–2023. The median age of patients was 3 years, with 91% unvaccinated or having unknown vaccination status. Most cases were import-associated, with 326 (96%) linked to international importations. The longest transmission chain lasted 63 days, but as of the end of 2023, the U.S. measles elimination status was maintained due to no sustained transmission for 12 months. However, the increase in cases in 2024 highlights the need for increased vaccination coverage, especially in under-vaccinated communities. The majority of cases were among unvaccinated individuals, with most imported cases linked to travel from the Eastern Mediterranean and African regions. The U.S. measles surveillance system performed well, with 93% of cases laboratory-confirmed. Despite high population immunity, efforts are needed to maintain elimination status by increasing routine vaccination, encouraging vaccination before international travel, and rapidly investigating suspected cases. The U.S. measles elimination status remains at risk due to global increases in measles incidence and decreases in vaccination coverage. The CDC recommends MMR vaccination before international travel to prevent importations. Maintaining high vaccination coverage is essential to prevent outbreaks and sustain elimination. Limitations include potential underreporting and the lack of data on some case investigations. Public health efforts should focus on identifying undervaccinated communities and improving vaccination coverage to prevent future outbreaks.The CDC reported 338 confirmed measles cases in the U.S. from January 1, 2020, to March 28, 2024. Of these, 97 (29%) occurred in the first quarter of 2024, a seventeenfold increase over the average of five cases per quarter from 2020–2023. The median age of patients was 3 years, with 91% unvaccinated or having unknown vaccination status. Most cases were import-associated, with 326 (96%) linked to international importations. The longest transmission chain lasted 63 days, but as of the end of 2023, the U.S. measles elimination status was maintained due to no sustained transmission for 12 months. However, the increase in cases in 2024 highlights the need for increased vaccination coverage, especially in under-vaccinated communities. The majority of cases were among unvaccinated individuals, with most imported cases linked to travel from the Eastern Mediterranean and African regions. The U.S. measles surveillance system performed well, with 93% of cases laboratory-confirmed. Despite high population immunity, efforts are needed to maintain elimination status by increasing routine vaccination, encouraging vaccination before international travel, and rapidly investigating suspected cases. The U.S. measles elimination status remains at risk due to global increases in measles incidence and decreases in vaccination coverage. The CDC recommends MMR vaccination before international travel to prevent importations. Maintaining high vaccination coverage is essential to prevent outbreaks and sustain elimination. Limitations include potential underreporting and the lack of data on some case investigations. Public health efforts should focus on identifying undervaccinated communities and improving vaccination coverage to prevent future outbreaks.