Post-tensioning was understood as early as 1860, but it was about 100 years before the first successful projects were built in the U.S. The subsequent 50 years saw rapid growth in the number of post-tensioned buildings and maturity in its construction and design technology. The performance and economical advantages of post-tensioned buildings have been recognized, and many other regions of the world are now embracing this U.S. spearheaded technology. This article reviews some of the critical milestones that have made post-tensioning the choice for many residential and commercial buildings.