Apical extracellular matrix (aECM) covers every surface of the body and exhibits tissue-specific structures that carry out specialized functions. This is particularly striking at sense organs, where aECM forms the interface between sensory neurons and the environment, and thus plays critical roles in how sensory stimuli are received. Here, we review the extraordinary adaptations of aECM across sense organs and discuss how differences in protein composition and matrix structure assist in sensing mechanical forces (tactile hairs, campaniform sensilla, and the tectorial membrane of the cochlea); tastes and smells (uniporous gustatory sensilla and multiporous olfactory sensilla in insects, and salivary and olfactory mucus in vertebrates); and light (cuticle-derived lenses in arthropods and mollusks). We summarize the power of using C. elegans, in which defined sense organs associate with distinct aECM, as a model for understanding the tissue-specific structural and functional specializations of aECM. Finally, we synthesize results from recent studies in C. elegans and Drosophila into a conceptual framework for aECM patterning, including mechanisms that involve transient cellular or matrix scaffolds, mechanical pulling or pushing forces, and localized secretion or endocytosis.