The quantum Hall (QH) effect, quantized Hall resistance combined with zero longitudinal resistance, is the characteristic experimental fingerprint of Chern insulators -topologically non-trivial states of two-dimensional matter with broken time-reversal symmetry. In Chern insulators, non-trivial bulk band topology is expressed by chiral states that carry current along sample edges without dissipation. The quantum anomalous Hall (QAH) effect refers to QH effects that occur in the absence of external magnetic fields due to spontaneously broken time-reversal symmetry. The QAH effect has now been realized in four different classes of two-dimensional materials: (i) thin films of magnetically (Cr-and/or V-) doped topological insulator (Bi,Sb) 2 Te 3 family, (ii) thin films of the intrinsic magnetic topological insulator MnBi 2 Te 4 , (iii) moiré materials formed from graphene, and (iv ) moiré materials formed from transition metal dichalcogenides. In this Article, we review the physical mechanisms responsible for each class of QAH insulator, highlighting both differences and commonalities, and comment on potential applications of the QAH effect.