At nuclear power reactors around the United States, quantities of spent or irradiated nuclear fuel are growing while owner-operator companies await the approval of a permanent storage facility. Some reactors have run out of space in their cooling pools and have had to resort to dry cask storage. The first half of this paper looks at the policy history of interim storage in the United States, discusses the current storage status at individual reactors, and then reviews the technologies available to deal with it. The second half of the paper considers the different options for dealing with this hazardous material in the interim, before a permanent high-level nuclear waste repository is opened, and examines the safety, security, transportation, economic, political, and other issues that bear on the choice of option.