Currents effects on waves have led to many developments in numerical wave modeling over the past two decades, from numerical choices to parameterizations. The performance of numerical models in conditions with strong currents is reviewed here, and observed strong effects of opposed currents and modulations of wave heights by tidal currents in several typical situations are interpreted. For current variations on small scales, the rapid steepening of the waves enhances wave breaking. Using different parameterizations with a dissipation rate proportional to some measure of the wave steepness to the fourth power, the results are very different, none being fully satisfactory, which points to the need for more measurements and further refinements of parameterizations. For larger-scale current variations, the observed modifications of the sea state are mostly explained by refraction of waves over currents and relative wind effects, that is, the wind speed relevant for wave generation is the speed in the frame of reference moving with the near-surface current. It is shown that introducing currents in wave models can reduce the errors on significant wave heights by more than 30% in some macrotidal environments, such as the coast of Brittany, in France. This large impact of currents is not confined to the locations where the currents are strongest, but also downwave from strong current gradients.