Election ballots in the United States contain the names of candidates for national, state, and local offices, as well as questions concerning important legislative issues.

Whether through touch-screen technology or the traditional paper ballot, U.S. voters make decisions on a wide range of offices and legislative proposals on election day. According to Washington political consultant Earl Bender, the United States has more than 176,000 elective offices within various levels and branches of government. This year, all 435 seats in the U.S. House of Representatives, 34 U.S. Senate seats, and 11 governorships are up for election, in addition to the presidency. Ballots also include contests for state and local government positions, from state supreme court justices and treasurers to city commissioners and school board members.

Voters can also participate in the legislative process on the state and local levels by approving and even making laws. Depending on state and local law, voters can call for a referendum, that is a vote to determine whether a measure passed by the state legislature becomes law. They can also add voter-initiated legislative measures or initiatives to ballots through a petition process. In many areas, voters also vote on local tax measures and the removal from office of elected officials.

State election laws determine ballot appearance and organization. Ballots can group candidates by party affiliation or by office. Some ballots allow voters to mark one party to vote for all candidates from that party. Every state offers a write-in option, so that voters can write in votes for unlisted candidates.

Ballot language options also vary by locality to reflect voter needs. Federal election law protects the rights of non-English speaking voters and requires bilingual ballots in jurisdictions with 10,000 or more non-English speakers.