Metastatic hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2-) breast cancer survival outcomes have improved significantly; however, once endocrine resistance develops, response rates to systemic treatments are limited. Within the developing field of antibody–drug conjugates, the TROPiCS-02 study showed a significant improvement in progression-free survival with sacituzumab govitecan compared with physician’s choice of chemotherapy in patients with endocrine-resistant, metastatic, HR+/HER2- breast cancer. Additionally, overall survival similarly improved (14.4 months versus 11.2 months, respectively). We discuss the role of sacituzumab govitecan and its role in practice, looking at the direct impact it has in metastatic HR+/HER2- breast cancer.