Membrane distillation is a process that utilizes differences in vapor pressure to permeate water through a macro-porous membrane and reject other non-volatile constituents present in the influent water. This review considers the fundamental heat and mass transfer processes in membrane distillation, recent advances in membrane technology, module configurations, and the applications and economics of membrane distillation, and identifies areas that may lead to technological improvements in membrane distillation as well as the application characteristics required for commercial deployment.