Fouling formation on heat exchanger surfaces due to crystallization of inverse solubility salts is one of the fundamental problems in process industries. Despite numerous studies carried out in recent years, comprehensive understanding of crystallization fouling mechanism remains a challenge to chemical engineers. In this review, we first focus on the basic crystallography during deposition of calcium salts, paying attention to crystal structures and crystal forms, as well as nucleation and the subsequent crystal growth process. We then endeavor to relate a number of factors to fouling rate, which may be classified into three categories: solution composition, operating parameters, and heat exchanger surface characteristics. Each aspect is discussed from the crystallization viewpoint (science) and in terms of possible industrial applications (practice). Combining the basic knowledge of crystallography with the information from experimental investigations, several fouling mitigation methods have also been described that may reduce fouling. It is hoped that some of the ideas discussed here will provide possible economic and environmental benefits. Finally, we also try to throw some light on the future direction for research.