With respect to performance, asymmetric code-based cryptography based on binary Goppa codes has been reported as a highly interesting alternative to RSA and ECC. A major drawback is still the large keys in the range between 50 and 100KB that prevented real-world applications of code-based cryptosystems so far. A recent proposal by Misoczki et al. showed that quasi-cyclic moderate-density parity-check (QC-MDPC) codes can be used in McEliece encryption, reducing the public key to just 0.6KB to achieve an 80-bit security level. In this article, we provide optimized decoding techniques for MDPC codes and survey several efficient implementations of the QC-MDPC McEliece cryptosystem. This includes high-speed and lightweight architectures for reconfigurable hardware, efficient coding styles for ARM’s Cortex-M4 microcontroller, and novel high-performance software implementations that fully employ vector instructions. Finally, we conclude that McEliece encryption in combination with QC-MDPC codes not only enables high-performance implementations but also allows for lightweight designs on a wide range of different platforms.