Over the last two decades, several thousand exoplanets have been identified, and their study has become a high scientific priority. Direct imaging of nearby exoplanets and the circumstellar disks in which they form and evolve is challenging due to the high contrast ratio and small angular separation relative to the central star. Exoplanets are typically within 1 arcsec of, and between 4 and 10 orders of magnitude fainter than, the stars they orbit. To meet these challenges, ground-based telescopes must be equipped with extreme adaptive optics (ExAO) systems optimized to acquire high-contrast images of the immediate surrounding of nearby bright stars. Current ExAO systems have the sensitivity to image thermal emission from young massive planets in near-IR, while future systems deployed on Giant Segmented Mirror Telescopes will image starlight reflected by lower-mass rocky planets. Thanks to rapid progress in optical coronagraphy, wavefront control, and data analysis techniques, direct imaging and spectroscopic characterization of habitable exoplanets will be within reach of the next generation of large ground-based telescopes.