The access network is the last loop, or last mile, in the provider network between the central office (CO) or point of presence (PoP) and the customer premises. Competitive pressure to provide high-bandwidth services (such as video) to consumers, and Ethernet transport to enterprises, is forcing service providers to rebuild their access networks. More optical fibers are being added in the last mile to meet these new bandwidth demands since legacy access networks have not been sufficient to support bandwidth-intensive applications. This chapter reviews the multiple definitions of “optical access” and the migration from direct copper loops to a variety of optical architectures, including Synchronous Optical Networking (SONET), Synchronous Digital Hierarchy (SDH), Fiber to the x (FTTx), Ethernet and wavelength delivery. Key business drivers such as carrier competition, bandwidth needs, and the reliability and service level agreement issues of optical technology are covered. The chapter concludes by considering the near future of optical access product trends and key optical deployment options in applications such as cellular backhaul. The data presented in this chapter is mainly based on our recent deployment experience in the North American optical access market segment.