This book chapter discusses recent advances in the fabrication of microscale surface patterns using chemical vapor deposition polymerization. Reactive poly(p-xylylene) (PPX) coatings are useful for their ability to immobilize specific biomolecules, as determined by the PPX functional group. PPXs can either be modified postdeposition, or they can be patterned onto a substrate in situ. Specific methods discussed in this progress report include microcontact printing, vapor-assisted micropatterning in replica structures, projection lithography-based patterning, and selective polymer deposition.