Innovations in medicine play an important role in improving patient care. The COVID-19 pandemic accelerated the development and implementation of innovative approaches to delivering medical care, including for people living with HIV. Many clinics moved to virtual consults, self-testing approaches for at-home testing were developed/implemented, and drug delivery by Uber and even drones were also explored. Innovations in diagnostics and therapeutics have been responsible for much of our success in revolutionizing HIV care over the last two decades. HIV RNA monitoring with extremely low levels of detection, and resistance testing with sophisticated interpretation systems are two examples of diagnostics that are now routine in many settings. Innovations have also been key to giant leaps in our improved therapeutics, examples being ritonavir boosting of PIs, and development of INSTI with high barriers to resistance such as DTG, BIC, and CAB, and, most recently, parenteral long-acting options allowing for just a few doses a year. Importantly, these innovations should always focus on both the healthcare provider as well as the patient. Close collaboration and mutual communication are needed to align the innovations with everyone’s needs. As the HIV population is aging, innovations are all the more needed to maintain and improve quality of life for the future.