For a study, it was determined that since the introduction of Haemophilus influenzae serotype b (Hib) conjugate vaccines in the United States, invasive H. influenzae disease epidemiology has changed, and racial disparities have not been recently described. Active population and laboratory-based surveillance for H. influenzae were conducted through Active Bacterial Core surveillance at 10 US sites. Data from 2008–2017 were used to estimate projected nationwide annual incidence, as cases per 100,000. During 2008–2017, Active Bacterial Core surveillance identified 7379 H. influenzae cases. Of 6,705 patients (90.9%) with reported race, 76.2% were White, 18.6% were Black, 2.8% were Asian/Pacific Islander, and 2.4% were American Indian or Alaska Native (AI/AN). The nationwide annual incidence was 1.8 cases/100,000. Incidence was highest among AI/AN populations (3.1) and lowest among Asian/Pacific Islander populations (0.8). Nontypeable H. influenzae caused the largest incidence within all races (1.3), with no striking disparities identified. Among AI/AN children aged less than 5 years, the incidence of H. influenzae serotype a (Hia) was 16.7 times higher and Hib incidence was 22.4 times higher than among white children. Hia incidence increased 13.6% annually among White children and 40.4% annually among Black children aged less than 5 years. Prevention tools are needed to decrease disparities affecting AI/AN children and address increasing Hia incidence in other communities.