The formation of highly polarized hyphae that grow by apical extension is a defining feature of the filamentous fungi. High-resolution microscopy and mathematical modeling have revealed the importance of the cytoskeleton and the Spitzenkorper (an apical vesicle cluster) in hyphal morphogenesis. However, the underlying molecular mechanisms remain poorly characterized. In this review, the pathways and functions known to be involved in polarized hyphal growth are summarized. A central theme is the notion that the polarized growth of hyphae is more complex than in yeast, though similar sets of core pathways are likely utilized. In addition, a model for the establishment and maintenance of hyphal polarity is presented. Key features of the model include the idea that polarity establishment is a stochastic process that occurs independent of internal landmarks. Moreover, the stabilization of nascent polarity axes may be the critical step that permits the emergence of a new hypha.