This article gives the principal findings of the first quantitative survey of the main towns and cities selling elephant ivory in the USA. The survey took place in 2006–7 with numbers and types of outlets, ivory items and prices recorded. Information was also collected on imports, craftsmen, buyers, law enforcement efforts and views about the future demand for ivory. We counted about 24,000 ivory items in nearly 660 outlets in 16 survey localities. While vendors say they are selling much less ivory nowadays, as demand has declined since the 1990 CITES ban, there has been a recent increase in ivory for sale on the Internet, with inadequate control measures in place. Most buyers are residents of the USA. New York City had the most items for sale, and most were antiques. East Asians have been smuggling in recently-carved items from Hong Kong and China in fairly significant quantities; these communities are selling worked ivory mainly in Honolulu, Los Angeles and San Francisco. Their outlets are not adequately checked and very few seizures have been made. These are probably the main outlets, along with the Internet, for recent (post CITES ban) ivory. Craftsmen work only part-time in ivory and number 120 to 200. They do repair work or craft small amounts and thus they require only small pieces of ivory, with enough being recycled in the USA to meet most of their demands.