Hygiene tissue paper properties are a function of fiber type, chemical additives, and machine technology. This review presents a comprehensive and systematic discussion about the effects of the type of fiber and machine technology on tissue properties. Advanced technologies, such as through-air drying, produce tissue with high bulk, softness, and absorbency. Conventional technologies, where wet pressing is used to partially dewater the paper web, produces tissue with higher density, lower absorbency, and softness. Different fiber types coming from various pulping and recycling processes are used for tissue manufacturing. Softwoods are mainly used as a source of reinforcement, while hardwoods provide softness and a velvet type surface feel. Non-wood biomass may have properties similar to hardwoods and/or softwoods, depending on the species. Mechanical pulps having stiffer fibers result in bulkier papers. Chemical pulps have flexible fibers resulting in better bonding ability and softness. Virgin fibers are more flexible and produce stronger and softer tissue. Recycled fibers are stiffer with lower bonding ability, yielding products that are weaker and less soft. Mild mechanical refining is used to improve limitations found in recycled fibers and to develop properties in virgin fibers. At the same time that refining increases strength, it also decreases bulk and water absorbency.