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This book contains the Proceedings of the Fifth Meeting on CPT and Lorentz Symmetry, held at Indiana University in Bloomington from June 28 to July 2, 2010. The Meeting focused on tests of these fundamental symmetries and on related theoretical issues, including scenarios for possible violations. Topics covered at the meeting include searches for CPT and Lorentz violations involving: birefringence and dispersion from cosmological sources, clock-comparison measurements, CMB polarization, electromagnetic resonant cavities, equivalence principle, gauge and Higgs particles, high-energy astrophysical observations, laboratory and gravimetric tests of gravity, matter interferometry, neutrino oscillations, oscillations and decays of K, D, B mesons, particle-antiparticle comparisons, post-newtonian gravity in the solar system and beyond, second- and third-generation particles, space-based missions, spectroscopy of hydrogen and antihydrogen, and spin polarized matter. Theoretical discussions include physical effects at the level of the Standard Model, General Relativity, and beyond; the possible origins and mechanisms for Lorentz and CPT violations; and related classical and quantum issues in field theory, particle physics, gravity, and string theory.