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This review considers research related to internal sizing agents. Such chemicals, when added as emulsions or in micellar form to slurries of cellulosic fibers before paper is made, can make the product resist water and other fluids. Significant progress has been achieved to elucidate the modes of action of alkylketene dimer (AKD), alkenylsuccinic anhydride (ASA), rosin products, and other sizing chemicals. Recent findings generally support a traditional view that efficient hydrophobation requires that the sizing chemicals contain hydrophobic groups, that they are efficiently retained on fiber surfaces during the papermaking process, that they become well distributed on a molecular scale, and that they need to be chemically anchored. A variety of studies have quantified ways in which internal sizing treatments tend to be inefficient, compared to what is theoretically possible. The inefficient nature of chemical and physical processes associated with internal sizing, as well as competing reactions and some interfering or contributing factors, help to explain apparent inconsistencies between the results of some recent studies.