Lattice QCD at the end of 2003

I review recent developments in lattice QCD. I first give an overview of its formalism, and then discuss lattice discretizations of fermions. We then turn to a description of the quenched approximation and why it is disappearing as a vehicle for QCD phenomenology. I describe recent claims for progress in simulations which include dynamical fermions and the interesting theoretical problems they raise. I conclude with brief descriptions of the calculations of matrix elements in heavy flavor systems and for kaons.