Rationally designed multifunctional plasmonic nanostructures efficiently integrate two or more functionalities into a single entity, for example, with both plasmonic and catalytic activity. This review article is focused on their synthesis and use in surface-enhanced Raman scattering (SERS) as a molecular spectroscopic technique with high sensitivity, fingerprint specificity, and surface selectivity. After a short tutorial on the fundamentals of Raman scattering and SERS in particular, applications ranging from chemistry (heterogeneous catalysis) to biology and medicine (diagnostics/imaging, therapy) are summarized.