Physical mechanisms of ductile damage in metal forming, experimental characterization methods for damage, and models predicting the damage level in formed components are reviewed. Applications of damage analysis in metal forming processes reveal that damage in metal formed parts is not failure, but a product property that accumulates between processes. Various metal forming process designs demonstrate that damage in formed products can be reduced and their performance can be increased. Static and fatigue strength, impact toughness, stiffness, and formability are typical examples of performance indicators that can be improved by damage-based process design. Potential scientific and technological challenges are addressed to realize damage-controlled metal forming processes.