All stars are born in molecular clouds, and most in giant molecular clouds (GMCs), which thus set the star formation activity of galaxies. We first review their observed properties, including measures of mass surface density, Σ, and thus mass, M. We discuss cloud dynamics, concluding most GMCs are gravitationally bound. Star formation is highly clustered within GMCs, but overall is very inefficient. We compare properties of star-forming clumps with those of young stellar clusters (YSCs). The high central densities of YSCs may result via dynamical evolution of already-formed stars during and after star cluster formation. We discuss theoretical models of GMC evolution, especially addressing how turbulence is maintained, and emphasizing the importance of GMC collisions. We describe how feedback limits total star formation efficiency, ε, in clumps. A turbulent and clumpy medium allows higher ε, permitting formation of bound clusters even when escape speeds are less than the ionized gas sound speed.