Our understanding of group A streptococcal disease epidemiology, pathogenesis, diagnosis, management and public health control continues to expand. This presentation will highlight key milestones on the path to our current understanding, and will discuss future research areas necessary to achieve control of group A streptococcal disease including priorities for vaccine development. The presentation, with a focus on clinical group A streptococcal disease, will provide a bookend to the 20th Lancefield Symposium, incorporating information presented over the course of the meeting where possible and where appropriate.