Cushman, DM, Markert, M, and Rho, M. Performance trends in large 10-km road running races in the United States. J Strength Cond Res 28(4): 892–901, 2014—Our study examines the current trends of runners participating in 10-km road races in the United States. Finish times and ages of all runners participating in 10 of the largest 10-km running races in the United States between 2002–2005 and 2011 were recorded. Linear regression analysis was performed to examine the trends for age, sex, and finishing time for all participants completing the course in <1 hour. A total of 408,296 runners were analyzed. There was a significant annual decrease in the ratio of men to women finishers (p < 0.001, r2 = 0.976). The average finishing time of the top 10 (men, p ≤ 0.05), 100 (men and women, p ≤ 0.05), and 1,000 (men and women, p < 0.01) significantly decreased annually. The total number of subhour finishers increased annually across all races (194 men per year, r2 = 0.584, p = 0.045; 161 women per year, r2 = 0.779, p = 0.008), whereas the percentage of overall finishers completing the course in less than an hour significantly declined for men and women (p ≤ 0.003). There was a significant trend toward younger men in all top groups except for the single fastest runner (p ≤ 0.017). Our study demonstrates that for large 10-km U.S. races: the top men and women seem to be getting faster; there are more subhour finishers, with increasingly more women accomplishing this feat compared with men; an increasingly lower percentage of overall finishers is finishing in <1 hour; and the fastest men are also increasingly younger.