Oceanic lee waves are generated in the deep stratified ocean by the flow of ocean currents over sea floor topography, and when they break, they can lead to mixing in the stably stratified ocean interior. While the theory of linear lee waves is well established, the nonlinear mechanisms leading to mixing are still under investigation. Tidally driven lee waves have long been observed in the ocean, along with associated mixing, but observations of lee waves forced by geostrophic eddies are relatively sparse and largely indirect. Parameterizations of the mixing due to ocean lee waves are now being developed and implemented in ocean climate models. This review summarizes current theory and observations of lee wave generation and mixing driven by lee wave breaking, distinguishing between steady and tidally oscillating forcing. The existing parameterizations of lee wave–driven mixing informed by theory and observations are outlined, and the impacts of the parameterized lee wave–driven mixing on simulations of large-scale ocean circulation are summarized. Expected final online publication date for the Annual Review of Fluid Mechanics, Volume 53 is January 7, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.