Chlamydial genital infection is common and asymptomatic in most cases. National screening efforts developed to educate practitioners, expand screening, and link testing to local health laboratories are not meeting the needs of populations at great risk of disease, including young racial/ethnic minority women and sexual minorities. The development and availability of newer diagnostics will likely make chlamydia testing more efficient and widely available for patients and providers. Practitioners are reminded to have a low threshold to offer testing and presumptive treatment to patients that are deemed at high risk of disease, particularly those who are challenging to engage in care. © 2013 Elsevier Inc.