Laser Powder Bed Fusion (L-PBF) technology is increasingly important for the fabrication of innovative engineering systems, including functionally integrated systems, bespoke medical implants, and high-value optimized structures. Increasingly, these engineered systems are well understood from a technical perspective; however, a remaining challenge of significance is associated with as-manufactured surface roughness. The surface condition is technically relevant for a series of potential practical issues associated with high-value products, including fatigue failure of dynamically loaded systems; osseointegration of bone implants; and technical function of hydraulic and thermofluidic products. This chapter compiles the current state of understanding of surface roughness induced by L-PBF technologies. These challenges are discussed from the perspective of the relevant identified practical issues: metal fatigue, osseointegration, and thermofluidic L-PBF applications.