An orbiting starshade could work with adaptive optics on a ground-based telescope to enable imaging and spectroscopic observation of Earth-like planets and planetary systems around Sun-like stars.  With 30 m class telescopes in both hemispheres, the entire sky is observable with exposure times of hours for 10 σ imaging per Earth-like target system at 10 pc distance. With ~ 70 sun-like stars (F, G, and K classes) within 10 pc, we could survey hundreds of planets with multicolor imaging to learn how many might resemble Earth and determine their orbits. Low resolution spectroscopy is also achievable. The higher angular resolution of the starshade – ground telescope combination can enable science that is not accessible with smaller space telescopes, and could potentially be implemented much sooner.