Piezoelectric materials possess the capability to interchangeably convert electrical energy into a mechanical response. While current piezoelectric materials exhibit strong properties, known limitations have inhibited further development. This review describes the ability to combine different piezoelectric materials into a composite to create well-rounded properties. The different types of connectivity classes are described as well as important design considerations and theoretical models. The contributions from the active and passive phases are outlined, focusing primarily on ferroelectric ceramics and polymer-based composites. The key advantage of piezoelectric composites is their ability to combine the flexibility of polymers with the high electromechanical coupling and piezoelectric coefficients of ferroelectric ceramics or single crystals appropriate for a variety of applications. Composites are prominent in medical ultrasound imaging and therapy, underwater acoustic sensing, industrial structural health monitoring, energy harvesting, and numerous other emerging applications. Expected final online publication date for the Annual Review of Materials Research, Volume 53 is July 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.