Cell behaviour and the cellular environment are stochastic. Phenotypes vary across isogenic populations and in individual cells over time. Here we will argue that to understand the abilities of cells we need to understand their stochastic nature. New experimental techniques allow gene expression to be followed in single cells over time and reveal stochastic bursts of both mRNA and protein synthesis in many different types of organisms. Stochasticity has been shown to be exploited by bacteria and viruses to decide between different behaviours. In fluctuating environments, cells that respond stochastically can out-compete those that sense environmental changes, and stochasticity may even have contributed to chromosomal gene order. We will focus on advances in modelling stochasticity, in understanding its effects on evolution and cellular design, and on means by which it may be exploited in biotechnology and medicine.