High temperature polymer electrolyte membrane fuel cells (HT-PEMFCs) are being studied due to a number of benefits offered versus their low temperature counterparts, including co-generation of heat and power, high tolerance to fuel impurities, and simpler system design. Approximately 90% of the literature on HT-PEM is related to the electrolyte and, for the most part, these electrolytes all use free phosphoric acid, or similar free acid, as the ion conductor. A major issue with using phosphoric acid based electrolytes is the free acid in the electrodes. The presence of the acid on the catalyst sites leads to poor oxygen activity, low solubility/diffusion, and can block electrochemical sites through phosphate adsorption. This review will focus on these issues and the steps that have been taken to alleviate these obstacles. The intention is this review may then serve as a tool for finding a solution path in the community.