In top down nanofabrication research facilities around the world, the direct-write high-resolution patterning tool of choice is overwhelmingly electron beam lithography. Remarkably small features can be written in a variety of polymeric resists [V. R. Manfrinato et al., Nano Lett. 14, 4406 (2014); V. R. Manfrinato, A. Stein, L. Zhang, Y. Nam, K. G. Yager, E. A. Stach, and C. T. Black, Nano Lett. 17, 4562 (2017)]. However, this technology, which in this article the authors will refer to as conventional electron beam lithography (CEBL), is reaching its practical resolution and precision limits [V. R. Manfrinato et al., Nano Lett. 14, 4406 (2014)]. Hydrogen depassivation lithography (HDL) [J. N. Randall, J. W. Lyding, S. Schmucker, J. R. Von Ehr, J. Ballard, R. Saini, and Y. Ding, J. Vac. Sci. Technol. B 27, 2764 (2009); J. N. Randall, J. B. Ballard, J. W. Lyding, S. Schmucker, J. R. Von Ehr, R. Saini, H. Xu, and Y. Ding, Microelectron. Eng. 87, 955 (2010)] is a different version of electron beam lithography that is not limited in resolution and precision in the way that CEBL is. It uses a cold field emitter, a scanning tunneling microscope (STM) tip, to deliver a small spot of electrons on a Si (100) 2 × 1 H-passivated surface to expose a self-developing resist that is a monolayer of H adsorbed to the Si surface. Subnanometer features [S. Chen, H. Xu, K. E. J. Goh, L. Liu, and J. N. Randall, Nanotechnology 23, 275301 (2012)], and even the removal of single H atoms can be routinely accomplished [M. A. Walsh and M. C. Hersam, Annu. Rev. Phys. Chem. 60, 193 (2009)]. It is known that the H desorption process at low biases is a multielectron process [E. Foley, A. Kam, J. Lyding, and P. Avouris, Phys. Rev. Lett. 80, 1336 (1998)], but the tunneling distribution of the electrons from the STM tip to the Si surface lattice is not known. The authors have developed a simple model that demonstrates that the combination of two highly nonlinear processes creates a much higher contrast exposure mechanism than CEBL. Currently, HDL has been used almost exclusively on the Si (100) surface and has a limited number of pattern transfer techniques including Si and Ge patterned epitaxy, selective atomic layer deposition of TiO2 followed by reactive ion etching [J. B. Ballard, T. W. Sisson, J. H. G. Owen, W. R. Owen, E. Fuchs, J. Alexander, J. N. Randall, and J. R. Von Ehr, J. Vac. Sci. Technol. B 31, 06FC01 (2013)], and selective deposition of dopant atoms for quantum devices and materials [Workshop on 2D Quantum MetaMaterials held at NIST, Gaithersburg, MD, April 25–26, 2018, edited by J. Owen and W. P. Kirk]. While the throughput of HDL is very low, going parallel in a big way appears promising [J. N. Randall, J. H. G. Owen, J. Lake, R. Saini, E. Fuchs, M. Mahdavi, S. O. R. Moheimani, and B. C. Schaefer, J. Vac. Sci. Technol. B 36, 6 (2018)]. However, the most exciting aspect of HDL is its atomic-scale resolution and precision, which is key to nanoscale research. The authors see HDL emerging as the ultimate high-resolution patterning tool in top down nanofabrication research facilities.