Precision fermentation is transforming the way in which food ingredients and products are produced. It is creating a revolution with new possibilities for producing food more sustainably. We consider the science and business of precision fermentation from concept to commercialization. We discuss the developments in microbial strain selection and engineering, the fermentation process, downstream processing for extraction of proteins and lipids. We examine some of the key issues for bringing precision-derived food ingredients to market including challenges in food regulations, sourcing alternative feedstocks to sugar and scaling of the fermentation process. Opportunities for advancing precision fermentation are highlighted.