Polyamines (PA) are ubiquitous, small, aliphatic cations found in all living cells. In recent years the importance of these molecules for macroalgae has become evident and a substantial body of knowledge has been accumulated over the last three decades. This review summarizes research on the PAs found in macroalgae, their transport and metabolism, and their biological significance in processes such as cell division, chloroplast development, and reproduction. The involvement of PAs in environmental stress responses in macroalgae is also addressed. The discussion of PAs in this review not only demonstrates that PAs play an important role in physiological processes in macroalgae, but also clearly demonstrates the similarities and differences between PA metabolism in macroalgae and higher plants. Key areas for future research are also discussed.