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This article offers an introduction to patient associations and movements in the USA. It focuses on the influence of these organizations on health policies, as well as the limits to their actions and the challenges they face. Considering both patient associations which target specific pathologies and protest movements that denounce dysfunctions in the American healthcare system, it emphasizes the heterogeneous and unequal dimensions of patient representation in the USA. Major successes such as Act Up and campaigns aiming to prevent breast cancer have attracted international attention. Nevertheless, these successes should not conceal the persistence of numerous silent groups representing the most vulnerable populations who are deprived of access to care, and whose voices remain unheard.