Multiscale, hierarchically patterned surfaces, such as lotus leaves, butterfly wings, adhesion pads of gecko lizards are abundantly found in nature, where microstructures are usually used to strengthen the mechanical stability while nanostructures offer the main functionality, i.e., wettability, structural color, or dry adhesion. To emulate such hierarchical structures in nature, multiscale, multilevel patterning has been extensively utilized for the last few decades towards various applications ranging from wetting control, structural colors, to tissue scaffolds. In this review, we highlight recent advances in scalable multiscale patterning to bring about improved functions that can even surpass those found in nature, with particular focus on the analogy between natural and synthetic architectures in terms of the role of different length scales. This review is organized into four sections. First, the role and importance of multiscale, hierarchical structures is described with four representative examples. Second, recent achievements in multiscale patterning are introduced with their strengths and weaknesses. Third, four application areas of wetting control, dry adhesives, selectively filtrating membranes, and multiscale tissue scaffolds are overviewed by stressing out how and why multiscale structures need to be incorporated to carry out their performances. Finally, we present future directions and challenges for scalable, multiscale patterned surfaces.