An overview of present understanding of microstructure in flowing suspensions is provided. An emphasis is placed on how the microstructure leads to observable bulk flow phenomena unique to mixtures. The bridge between the particle and bulk scales is provided by the mixture rheology; one focus of the review is on work that addresses the connection between microstructure and rheology. The non-Newtonian rheology of suspensions includes the well-known rate dependences of shear thinning and thickening, which have influence on bulk processing of suspensions. Shear-induced normal stresses are also measured in concentrated suspensions and include normal stress differences, and the isotropic particle pressure. Normal stresses have been associated with shear-induced migration, and thus have influence on the ultimate spatial distribution of solids, as well as the flow rate during processing; a second focus is on these uniquely two-phase behaviors and how they can be described in terms of the bulk rheology. An important bulk fluid mechanical consequence of normal stresses is their role in driving secondary flows.