Epizonal base and precious metal deposits makeup a range of familiar deposit styles including porphyry copper-gold, epithermal veins and stockworks, carbonate-replacement deposits, and polymetallic volcanic rock-hosted (VHMS) deposits. They occur along convergent plate margins and are invariably associated directly with active faults and volcanism. They are complex in form, variable in their characteristics at all scales, and highly localized in the earth’s crust. More than a century of detailed research has provided an extensive base of observational data characterizing these deposits, from their regional setting to the fluid and isotope chemistry of mineral deposition. This has led to a broad understanding of the large-scale hydrothermal systems within which they form. Low salinity vapor, released by magma crystallization and dispersed into vigorously convecting groundwater systems, is recognized as a principal source of metals and the gases that control redox conditions within systems. The temperature and pressure of the ambient fluid anywhere within these systems is close to its vapor-liquid phase boundary, and mineral deposition is a consequence of short timescale perturbations generated by localized release of crustal stress. However, a review of occurrence data raises questions about ore formation that are not addressed by traditional genetic models. For example, what are the origins of banding in epithermal veins, and what controls the frequency of oscillatory lamination? What controls where the phenomenon of mineralization occurs, and why are some porphyry deposits, for example, so much larger than others? The distinctive, self-organized characteristics of epizonal deposits are shown to be the result of repetitive coupling of fracture dilation consequent on brittle failure, phase separation (“boiling”), and heat transfer between fluid and host rock. Process coupling substantially increases solute concentrations and triggers fast, far-from-equilibrium depositional processes. Since these coupled processes lead to localized transient changes in fluid characteristics, paragenetic, isotope, and fluid inclusion data relate to conditions at the site of deposition and only indirectly to the characteristics of the larger-scale hydrothermal system and its longer-term behavior. The metal concentrations (i.e. grade) of deposits and their internal variation is directly related to the geometry of the fracture array at the deposit scale, whereas finer-scale oscillatory fabrics in ores may be a result of molecular scale processes. Giant deposits are relatively rare and develop where efficient metal deposition is spatially focused by repetitive brittle failure in active fault arrays. Some brief case histories are provided for epithermal, replacement, and porphyry mineralization. These highlight how rock competency contrasts and feedback between processes, rather than any single component of a hydrothermal system, govern the size of individual deposits. In turn, the recognition of the probabilistic nature of mineralization provides a firmer foundation through which exploration investment and risk management decisions can be made.