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Dengue remains the most important arboviral disease in the Americas and a growing global public health threat. The region experienced the largest dengue epidemic in recorded history during 2023–2024, with more than 13 million reported cases in 2024 alone, reflecting the combined effects of rapid urbanization, climate variability, population mobility, persistent social inequities, and weakened vector-control programs. This review summarizes and expands on the principal discussions of the First Dengue Summit of the Dengue Initiative of the Americas, held in Cartagena, Colombia, in September 2025. Major themes included the changing epidemiology of dengue; implementation and development of new-generation vaccines, including TAK-003 and Butantan-DV; advances in digital surveillance, outbreak forecasting, and clinical management; and integrated vector-control strategies. Particular attention is given to Wolbachia-mediated population replacement, supported by evidence from a cluster-randomized trial in Indonesia and large-scale quasi-experimental evaluations in Colombia and Brazil, which show substantial and sustained reductions in dengue incidence and hospitalization. In the Aburrá Valley, Colombia, city-wide deployment in Bello, Medellín, and Itagüí was associated with reductions exceeding 90% in notified dengue incidence where Wolbachia became established. The review also examines mathematical modeling, artificial intelligence, climate-informed surveillance, and integrated public health approaches. Persistent challenges include financial sustainability, healthcare inequities, climate change, insecticide resistance, and heterogeneous surveillance and health-system capacity. Coordinated, multisectoral, sustainable strategies that integrate vaccination, vector control, surveillance, community participation, and healthcare strengthening are essential to reduce the dengue burden and improve regional resilience.