Irradiation growth is thought to occur when there is an anisotropic distribution of sinks receiving a net flux of vacancies and this anisotropy is different from that of the distribution of sinks receiving a net flux of self-interstitials. For a complete understanding of irradiation growth one must identify the possible sinks, identify the source of the anisotropy and rationalize the distribution of point defects amongst the sinks. Early theoretical models for growth attempted to explain what appeared to be relatively straightforward behaviour with simple models and microstructures. However, experimental observations in the last few years have shown that the range of irradiation growth behaviour of alpha-zirconium alloys is more varied, that a wider variety of sinks must be considered, and that there are more potential sources of anisotropy than was previously recognized. The important new experimental observations which influence our perception of the growth phenomenon in zirconium alloys include the growth of single crystals, accelerating growth in annealed material with the coincident appearance of vacancy loops on the basal planes, the occurrence of “negative” growth, i.e., contractions along prism directions, the absence of a pronounced effect of grain size on the long term growth rate at low temperatures, and the presence of intergranular constraints prior to irradiation. With the greater complexity of behaviour now being observed, it is necessary to apply new theoretical concepts to assist in understanding growth, e.g., the potential role of anisotropic diffusion in segregating point defects to different sinks and “growth” caused by the anisotropic relaxation of intergranular constrains. These can be combined with earlier ideas to predict a variety of growth behaviours, including “negative growth”. Because the most important physical information required for theoretical treatments of growth, i.e, the characteristics of vacancies and self interstitial atoms, are still poorly understood, it is almost impossible to test rigorously any particular theoretical concept and a complete picture of growth has yet to emerge.