Ammonia (NH3) is an excellent hydrogen (H2) carrier that is easy to bulk manufacture, handle, transport, and use. NH3 is itself combustible and could potentially become a clean transport fuel for direct use in internal combustion engines (ICEs). This technical review examines the current state of knowledge of NH3 as a fuel in ICEs on its own or in mixtures with other fuels. A particular case of interest is to partially dissociate NH3 in situ to produce an NH3/H2 mixture before injection into the engine cylinders. A key element of the present innovation, the presence of H2 is expected to allow easy control and enhanced performance of NH3 combustion. The key thermochemical properties of NH3 are collected and compared to those of conventional and alternative fuels. The basic combustion characteristics and properties of NH3 and its mixtures with H2 are summarized, providing a theoretical basis for evaluating NH3 combustion in ICEs. The combustion chemistry and kinetics of NH3 combustion and mechanisms of NOx formation and destruction are also discussed. The potential applications of NH3 in conventional ICEs and advanced homogenous charge compression ignition (HCCI) engines are analyzed.