This chapter reviews the most significant advancements in the context of metamaterial (MTM) leaky wave antennas (LWAs). A brief review of the mechanism of leaky wave radiation along with an important class of MTMs known as composite right/left-handed (CRLH) structures is presented. Then, recent outstanding works in the area of CRLH LWAs are reported in detail. These works include the application of electronic control, substrate integrated waveguides, dual band and wideband performance, ferrite loaded waveguides, and split-ring-resonator (SRR)-based MTMs in LWAs. Also, the benefits of LWAs to design high gain active structures, reflecto-directive systems, wideband dual-layer substrate integrated waveguide antennas and conformal antennas are discussed.