“…Top-down MS was first coined by McLafferty and co-workers in 1999, and the early top-down MS studies generally took a targeted approach focusing on offline purified single proteins or simple protein mixtures due to the inherent limitations of intact protein analysis. − Top-down proteomics, pioneered by Kelleher and co-workers, includes the front-end fractionation of intact proteins, high-resolution MS, and back-end informatics, making it possible to identify proteins from complex mixtures. ,, In the past decade, top-down proteomics has experienced rapid growth due to many technological advances, − thereby enabling the applications of top-down proteomics to complex protein mixtures and for understanding basic biological functions, unraveling disease mechanisms, and discovering new biomarkers. − However, many challenges still exist for top-down MS-based proteomics, especially protein solubility, dynamic range, proteome complexity, data analysis, proteoform–function relationships, and analytical throughput of top-down proteomics for precision medicine (Figure ). Previous reviews on top-down proteomics have already described various aspects of top-down proteomics such as technological advancements and biomedical applications, among others. − ,,,− In this Account & Perspective, we will focus on the most pressing challenges currently facing the top-down proteomics field. We illustrate how recent and future technological innovation could help address these challenges to advance top-down proteomics toward the mainstream.…”