Declines of freshwater mussel (order Unionida) populations worldwide are attributed to habitat degradation, pollution, and invasive species, among other factors. However, these purported causes do not fully explain the enigmatic decline and large-scale die-offs of mussels that have occurred in apparently healthy streams across a wide geographic region. The roles of the microbiota and pathogens in mussel health have been understudied, and, as a result, few data exist to compare the microbiota of healthy mussels to that of stressed or dying mussels. Captive propagation and stocking programs have expanded across the globe without standard diagnostic protocols to assess health or potential diseases in hatchery-reared or wild stocks. Nonindigenous species, contaminants of emerging concern, and anthropogenic climate change could alter adversely the underlying processes that support mussel health, such as nutritional status and microbial composition, and these factors could increase the risk for outbreaks of opportunistic and emergent mussel disease. We propose a coordinated, collaborative, and multidisciplinary effort to advance methods for assessing freshwater mussel health. We identify research and resources needed to answer central questions surrounding mussel health, including identifying potential agents of disease, defining clinical signs of declining condition, refining stressspecific biomarkers for health assessment, and developing protocols specific for mussels.