The most powerful persistent accelerators in the Universe are jetted active galaxies. Galaxies whose jets are directed towards Earth, so called blazars, dominate the extragalactic γ-ray sky. Still, most of the highest-energy accelerators likely elude detection. These extreme blazars, whose radiated energy can peak beyond 10 TeV, are ideal targets to study particle acceleration and radiative processes, and may provide links to cosmic rays and astrophysical neutrinos. The growing number of extreme blazars observed at TeV energies has been critical for the emergence of γ-ray cosmology, including measurements of the extragalactic background light, tight bounds on the intergalactic magnetic field, and constraints on exotic physics at energies inaccessible with human-made accelerators. Tremendous progress is expected in the decade to come, particularly with the deployment of the Cherenkov Telescope Array.