Solar energy production, one of the world's most important unsolved problems, has the potential to be a source of clean, renewable energy if scientists can find a way of generating cheap and efficient solar cells. Generation of multiple excitons from single photons is one way to increase the efficiency of solar energy collection, but the process suffers from low efficiency in bulk materials. An increase of multiexciton generation efficiency in nanocrystals was proposed by Nozik in 2002 and demonstrated by Schaller and Klimov in 2004 in PbSe nanocrystals. Since then, scientists have observed efficient multiexciton generation in nanostructures made of many semiconductors using various measurement techniques. Although the experimental evidence of efficient carrier multiplication is overwhelming, there is no complete theory of this phenomenon. Researchers cannot develop such a theory without a self-consistent description of the Coulomb interaction and a knowledge of mechanisms of electron and hole thermalization in nanostructures. The full theoretical description requires the strength of the Coulomb interaction between exciton and multiexciton states and the thermalization rates, which both vary with the dimensionality of the confining potential. As a result, the efficiency of multiexciton generation depends strongly on the material and the shape of the nanostructure. In this Account, we discuss the theoretical aspects of efficient carrier multiplication in nanostructures. The Coulomb interaction couples single excitons with multiexciton states. Phenomenological many-electron calculations of the evolution of single-photon excitations have shown that efficient multiexciton generation can exist only if the rate of the Coulomb mixing between photo-created exciton and biexciton states is significantly faster than the rate of exciton relaxation. Therefore, to increase multiexciton generation efficiency, we need to either increase the exciton-biexciton mixing rate or suppress the exciton relaxation rate. Following this simple recipe, we show that multiexciton generation efficiency should be higher in semiconductor nanorods and nanoplatelets, which have stronger exciton-biexciton coupling due to the enhancement of the Coulomb interaction through the surrounding medium.