Hydrophobic membranes used in membrane distillation (MD) systems are often subject to wetting during long-term operation. Thus, it is of great importance to fully understand factors that influence the wettability of hydrophobic membranes and their impact on the overall separation efficiency that can be achieved in MD systems. This Critical Review summarizes both fundamental and applied aspects of membrane wetting with particular emphasis on interfacial interaction between the membrane and solutes in the feed solution. First, the theoretical background of surface wetting, including the relationship between wettability and interfacial interaction, definition and measurement of contact angle, surface tension, surface free energy, adhesion force, and liquid entry pressure, is described. Second, the nature of wettability, membrane wetting mechanisms, influence of membrane properties, feed characteristics and operating conditions on membrane wetting, and evolution of membrane wetting are reviewed in the context of an MD process. Third, specific membrane features that increase resistance to wetting (e.g., superhydrophobic, omniphobic, and Janus membranes) are discussed briefly followed by the comparison of various cleaning approaches to restore membrane hydrophobicity. Finally, challenges with the prevention of membrane wetting are summarized, and future work is proposed to improve the use of MD technology in a variety of applications.