PQShield BSI Google Crypto4A Technologies BSI Stateful Hash-Based Signature Schemes (Stateful HBS) such as LMS, HSS, XMSS and XMSS^MT combine Merkle trees with One-Time Signatures (OTS) to provide signatures that are resistant against attacks using large-scale quantum computers. Unlike conventional stateless digital signature schemes, Stateful HBS have a state to keep track of which OTS keys have been used, as double-signing with the same OTS key allows forgeries. This document provides guidance and catalogs security considerations for the operational and technical aspects of deploying systems that rely on Stateful HBS. Management of the state of the Stateful HBS, including any handling of redundant key material, is a sensitive topic. This document describes some approaches to handle the associated challenges. It also describes the challenges that need to be resolved before certain approaches should be considered.