In this chapter, we provide a comprehensive review of multimode communications using OAM. The fundamentals of OAM are introduced first followed by the techniques for OAM generation, multiplexing/demultiplexing, and detection. We then present recent research efforts to free-space communication links and fiber-based transmission links using OAM multiplexing together with optical signal processing using OAM (data exchange, add/drop, multicasting, monitoring, and compensation). Future challenges of OAM communications are discussed at the end.