Interactions of macromolecules with growing crystalline surfaces play an important role in biomineralization, determine survival of some organisms at low temperatures, and offer a range of potential industrial applications. The current understanding of crystal growth processes in the presence of macromolecules, including peptides and proteins, is reviewed, with a focus on interactions between macromolecules and surfaces of crystalline materials, macromolecule adsorption on different types of crystal surfaces, crystallization kinetics in the presence of macromolecular additives, macromolecule incorporation, and defect generation. Throughout, special attention is paid to the selectivity of macromolecule adsorption on, and incorporation within, crystal surfaces. The special role played by the size and complexity of macromolecules as compared to other crystallization additives is emphasized.