We summarize the observations of the spin periods of rapidly accreting neutron stars. If gravitational radiation is responsible for balancing the accretion torque at the observed spin frequencies of ~300 Hz, then the brightest of these systems make excellent gravitational wave sources for LIGO-II and beyond. We review the recent theoretical progress on two mechanisms for gravitational wave emission: mass quadrupole radiation from deformed neutron star crusts and current quadrupole radiation from r-mode pulsations in neutron star cores.