Oceanic flows are turbulent and multi-scale in nature, and are composed of fast internal waves and slowly evolving balanced eddies. Contrary to conventional wisdom in physical oceanography, the past two decades of
in situ
, satellite altimeter and realistically forced global scale ocean model outputs have revealed that internal gravity waves can have comparable or higher energy levels than geostrophically balanced flows at 10–100 km scales in different parts of the world’s oceans. These relatively recent findings have fuelled a wide range of research activities aimed at understanding how fast internal gravity waves interact with slowly evolving balanced flows, particularly with the goal of deducing whether internal waves can form an energy sink for oceanic balanced flows. In this paper, we comprehensively review theoretical, numerical and observational investigations undertaken to study internal wave-balance flow exchanges. Theoretical calculations, inspired by different wave-balance regimes seen in observational and global ocean model outputs, are used to point out that internal waves can affect balanced flow dynamics. The theoretical results are followed up by a detailed discussion of numerical results on wave-balance interactions in a broad set of parameter regimes. The numerical results reveal how different kinds of waves exchange energy with balance flow, affect energy flux across scales of balanced flow and facilitate the generation of small-scale dissipative balanced flow structures. The numerical simulation results and global internal wave energy and balanced energy maps are used to conjecture that out of the 0.8 TW of power going to balanced flow kinetic energy in the ocean, at least 0.1 TW could be dissipated by internal gravity waves. We therefore hypothesize that internal waves can form a non-negligible energy sink for balanced flow in the world’s oceans.