Twinning is a major mechanism of plastic deformation in hexagonal close-packed (hcp) structures. However, a mechanistic understanding of twin nucleation and growth has yet to be established. This paper reviews the recent progress in the understanding of twinning in hcp materials—particularly the newly discovered phase transformation-mediated twinning mechanisms—in terms of crystallographical analysis, theoretical mechanics calculations, and numerical simulations. Moreover, the relationship between phase transformation-mediated twinning mechanisms and twinning dislocations are presented, forming a unified understanding of deformation twinning. Finally, this paper also reviews the recent studies on transformation twins that are formed in hcp martensite microstructures after various phase transformations, highlighting the critical role of the mechanical loading in engineering a transformation twin microstructure.