I outline the theory of accretion onto black holes, and its application to observed phenomena such as X-ray binaries, active galactic nuclei, tidal disruption events, and gamma-ray bursts. The dynamics as well as radiative signatures of black hole accretion depend on interactions between the relatively simple black-hole spacetime and complex radiation, plasma and magnetohydrodynamical processes in the surrounding gas. I will show how transient accretion processes could provide clues to these interactions. Larger global magnetohydrodynamic simulations as well as simulations incorporating plasma microphysics and full radiation hydrodynamics will be needed to unravel some of the current mysteries of black hole accretion.