Understanding and unlocking the potential of semiconductor nanocrystals (NCs) is important for future applications ranging from biomedical imaging contrast agents to the next generation of solar cells and LEDs. Silicon NCs (Si NCs) have key advantages compared with other semiconductor NCs due to silicon's high natural abundance, low toxicity and strong biocompatibility, and unique size, and surface dependent optical properties. In this Account, we review and discuss the synthesis, surface modification, purification, optical properties, and applications of Si NCs. The synthetic methods used to make Si NCs have improved considerably in the last 5-10 years; highly monodisperse Si NCs can now be produced on the near gram scale. Scaled-up syntheses have allowed scientists to drive further toward the commercial utilization of Si NCs. The synthesis of doped Si NCs, through addition of a simple elemental precursor to a reaction mixture or by the production of a single source precursor, has shown great promise. Doped Si NCs have demonstrated unique or enhanced properties compared with pure Si NCs, for example, magnetism due to the presence of magnetic metals like Fe and Mn. Surface reactions have reached a new level of sophistication where organic (epoxidation and diol formation) and click (thiol based) chemical reactions can be carried out on attached surface molecules. This has led to a wide range of biocompatible functional groups as well as a degree of emission tuneability. The purification of Si NCs has been improved through the use of size separation columns and size selective precipitation. These purification approaches have yielded highly monodisperse and pure Si NCs previously unachieved. This has allowed scientists to study the size and surface dependent properties and toxicity and enabled the use of Si NCs in biomedical applications. The optical properties of Si NCs are complex. Using a combination of characterization techniques, researchers have explored the relation between the optical properties and the size, surface functionalization, and preparation method. This work has led to a greater fundamental understanding of the unique optical properties of Si NCs. Si NCs are being studied for a wide range of important applications, including LEDS with tunable electroluminescence ranging from NIR to yellow, the encapsulation of Si NCs within micelles terminated with proteins to allow targeted in vivo imaging of cells, Si NC-polymer hybrid solar cells, and the use of Si NCs in battery anodes with high theoretical capacity and good charge retention.