The US President’s Emergency Plan for AIDS Relief (PEPFAR) supported 3.88 million voluntary medical male circumcision (VMMC) procedures in fiscal year 2018 alone, reaching a cumulative total of about 18.9 million men and boys in priority countries in eastern and southern Africa since the programme’s inception. The VMMC section of PEPFAR’s 2019 annual report summarises progress in providing VMMC in 14 countries and describes how PEPFAR is implementing innovative solutions to barriers to VMMC uptake. Previous PEPFAR annual reports are also available.