Deformation twinning is a prevalent plastic deformation mode in hexagonal close-packed (HCP) materials, such as magnesium, titanium, and zirconium, and their alloys. Experimental observations indicate that these twins occur heterogeneously across the polycrystalline microstructure during deformation. Morphological and crystallographic distribution of twins in a deformed microstructure, or the so-called twinning microstructure, significantly controls material deformation behavior, ductility, formability, and failure response. Understanding the development of the twinning microstructure at the grain scale can benefit design efforts to optimize microstructures of HCP materials for specific high-performance structural applications. This article reviews recent research efforts that aim to relate the polycrystalline microstructure with the development of its twinning microstructure through knowledge of local stress fields, specifically local stresses produced by twins and at twin/grain–boundary intersections on the formation and thickening of twins, twin transmission across grain boundaries, twin–twin junction formation, and secondary twinning.