The COVID-19 pandemic has exposed multiple vulnerabilities in the U.S. lettuce value chain. Restaurants and other food service operations closed almost overnight, leaving farmers with millions of dollars of excess lettuce. Because of the rigid value chain, farmers were forced to decide whether to harvest their crops for donation, try to find new customers, or plow their crops under. Close working and living conditions increase farmworkers’ risk of contracting COVID-19. Though many operations have implemented safety measures to protect farmworkers from COVID-19 in the short-term, larger structural changes must be made to provide workers with fair wages, access to health insurance and paid time off, and affordable housing. This review outlines the current value chain of lettuce in the U.S. and the disruptions caused by COVID-19, analyzes the impacts on farmworker health and safety, and offers recommendations for a more resilient lettuce value chain.