Hydrogen is expected to play an important role as an energy carrier in a future, more sustainable society. However, its compact, efficient, and safe storage is an unresolved issue. One of the main options is solid-state storage in hydrides. Unfortunately, no binary metal hydride satisfies all requirements regarding storage density and hydrogen release and uptake. Increasingly complex hydride systems are investigated, but high thermodynamic stabilities as well as slow kinetics and poor reversibility are important barriers for practical application. Nanostructuring by ball-milling is an established method to reduce crystallite sizes and increase reaction rates. Since five years attention has also turned to alternative preparation techniques that enable particle sizes below 10 nanometers and are often used in conjunction with porous supports or scaffolds. In this Review we discuss the large impact of nanosizing and -confinement on the hydrogen sorption properties of metal hydrides. We illustrate possible preparation strategies, provide insight into the reasons for changes in kinetics, reversibility and thermodynamics, and highlight important progress in this field. All in all we provide the reader with a clear view of how nanosizing and -confinement can beneficially affect the hydrogen sorption properties of the most prominent materials that are currently considered for solid-state hydrogen storage.