Dengue viruses are maintained in endemic transmission cycles in tropical urban areas where epidemics periodically occur. Until about 30 years ago, there were long intervals (10–40 years) between epidemics but they are now occurring in many areas at 3–5-year intervals. These epidemics are most likely caused by virus strains with different epidemic potential. Accompanying this increased frequency in epidemic activity has been a change in the disease pattern with cases of the severe form of dengue (dengue hemorrhagic fever) becoming much more common. The occurrence of these factors and the expanding geographic distribution of dengue hemorrhagic fever in the past 15 years have made it necessary to re-evaluate currently recommended methods for prevention and control. The result has been increasing emphasis on the development of effective sustainable Aedes aegypti control programs based on source reduction using community participation. A brief overview of global programs using this approach is presented with emphasis on the Puerto Rican program, one of the earliest developed.