The powerful lasers being constructed for inertially confined fusion generate enormous pressures extremely rapidly. These extraordinary machines both motivate the need and provide the means to study materials under extreme pressures and loading rates. In this frontier of materials science, an experiment may last for just 10s of nanoseconds. Processes familiar at ambient conditions, such as phase transformations and plastic flow, operate far from equilibrium and show significant kinetic effects. Here we describe recent developments in the science of metal deformation and phase transitions at extreme pressures and strain rates. Ramp loading techniques enable the study of solids at high pressures (100s of GPa) at moderate temperatures. Advanced diagnostics, such as in situ x-ray scattering, allow time-resolved material characterization in the short-lived high-pressure state, including crystal structure (phase), elastic compression, the size of microstructural features, and defect densities. Computer simulation, especially molecular dynamics, provides insight into the mechanisms of deformation and phase change.