Asphaltene precipitation and deposition have been a formation damage problem for decades, with the most devastating effects being wettability alteration and permeability impairment. To this effect, a critical look into the laboratory studies and models developed to quantify/predict permeability and wettability alterations are reviewed, stating their assumptions and limitations. For wettability alterations, the mechanism is predominantly surface adsorption, which is controlled by the asphaltene contacting minerals as they control the surface chemistry, charge, and electrochemical interactions. The most promising wettability alteration evaluation techniques are nuclear magnetic resonance, ζ potential, and the use of high-resolution microscopy. The integration of such techniques, which is still missing, would reinforce the understanding of asphaltene interaction with rock minerals (especially clays), which holds the key to developing a strategy for modeling wettability alteration. With regard to permeability impairment, surface deposition, pore plugging, and fine migration have been identified as the dominant mechanisms with several models reporting the simultaneous existence of multiple mechanisms. Existing experimental findings showed that asphaltene deposition is non-uniform due to mineral distribution which further complicates the modeling process. It also remains a challenge to separate changes due to adsorption (wettability changes) from those due to pore size reduction (permeability impairment).