In an integrative review of the literature covering the period 2004-2016, the author presents a current picture of the situation of people who are deaf or hard of hearing (DHH) relative to employment and careers--particularly the barriers, facilitators, and stress levels experienced by working DHH adults. First, an overview is provided of findings from recent reports on employment outcomes for people who are DHH. Second, the author reviews the literature on employment and workplace barriers, facilitators, and accommodations for people who are DHH, and relates findings about DHH people's workplace-related stress and fatigue levels and the associated issues of job demand, job control, and social support in the workplace. The article concludes with a discussion of the implications of these findings, in particular the ways in which barriers to full participation of DHH people in the labor market can be addressed.