Sudden cardiac death (SCD) is a major public health problem worldwide. Despite many advances in the care of sudden cardiac arrest (SCA), 90% of individuals with SCA do not survive. A major challenge in SCD prevention is that while the highest incidence of SCD is in known high-risk groups such as patients with prior sustained ventricular arrhythmias and those with heart failure, the absolute number of SCD events is highest among individuals who are not presently known to be at an increased risk of SCD. Another difficulty is that while current guidelines recommend implantable cardioverter defibrillators for individuals at a high risk of SCD, a large number of these patients never receive a life-saving therapy from their device. How to identify high-risk patients in low-risk groups and low-risk patients in high-risk groups remains a fundamental challenge. Recognizing the major impact of SCD and SCA on the lives of many individuals and the enormous burden of SCD and SCA, the Heart Rhythm Society convened a think tank meeting of stakeholders, "The Present and The Future of Risk Stratification for and Prevention of SCD." The objectives of the meeting were to 1) improve understanding of the current public health impact of SCD, 2) review the current state of prediction and prevention of SCD, 3) identify gaps in prediction and prevention of SCD, and 4) develop an action plan to address the identified gaps. This manuscript summarizes the proceedings of the meeting and proposes a plan for reducing the burden and impact of SCD.