A growing body of work has demonstrated that cancer metastasis is not a random spontaneous event; rather it is the culmination of a cascade of priming steps through which a sub-population of the tumor cells acquires invasive traits while readying a permissive environment, termed the pre-metastatic niche, in which distant metastases can occur. Signals from the primary tumor mobilize and adapt immune cells as well as directly communicate with distant niche cells to induce a broad spectrum of adaptations in target organs, including the induction of angiogenesis, inflammation, extracellular matrix remodeling, and metabolic reprogramming. Together these interactions facilitate the formation of a pre-metastatic niche composed of a variable mix of resident and recruited immune cells, endothelial cells, and stromal cells connected through a complex signaling network that we are only beginning to understand. Here we summarize the latest findings on how cancer induces and guides the formation of this pre-metastatic niche as well as potential prognostic markers and therapeutic targets that may lead to a better understanding and effective treatment of metastatic disease.