Grain refining is considered one of the most important liquid metal processing processes for aluminum alloys. Three different types of grain morphology are possible: columnar, twin columnar and equiaxed. The present work reviews most of the theories that were proposed during the past three decades. These theories were mainly based on thermal analysis and thermodynamics to explain the mechanisms of grain refining of Al-Si based alloys, including the role of the master alloy used i.e., Al-B, Al-Ti, and Al-Ti-B alloys. Other aspects were also examined, mainly the interactions between Si and/or Sr and the grain refining master alloy, superheating of the molten metal as well as holding time prior to casting. This phenomenon is normally termed “poisoning” since it reduces the effectiveness of the added grain refiners. The effects of grain refining on the alloy microstructural characteristics, mechanical properties, machinability, hot tearing etc. have not been addressed in the present article.