Because of the complexity of fouling, it has been primarily studied as individual mechanisms. However, in actual field conditions, multiple mechanisms may be present. Little is understood about how different mechanisms interact. In cooling tower applications, water is treated with corrosion inhibitors and biocides to eliminate biological and corrosion fouling mechanisms. The fouling in cooling towers is, therefore, typically a combination of precipitation and particulate fouling. This paper presents a literature survey of research in the area of particulate, precipitation, and combined fouling modes in heat exchangers that use cooling tower water. Several experiments, models, and correlations are briefly described. The article concludes with a review section on long-term fouling data.