Diamond can be grown as an equilibrium phase from a liquid metal solution containing carbon at high pressures and high temperatures. Diamond can also be grown as a metastable phase at subatmospheric pressures and moderate temperatures from hydrocarbon gases in the presence of atomic hydrogen. Atomic hydrogen serves several critical roles in CVD diamond growth, namely: 1) stabilization of the diamond surface, 2) reduction of the size of the critical nucleus, 3) “dissolution” of carbon in the gas, 4) production of carbon solubility minimum, 5) generation of condensable carbon radicals in the gas, 6) abstraction of hydrogen from hydrocarbons attached to surface, 7) production of vacant surface sites, 8) etching of graphite, 9) suppression of polycycic aromatic hydrocarbons. A search for substitutes for atomic hydrogen have been unsuccessful to date but several new processes that do not use atomic hydrogen are currently under study.