Stars form in cold clouds of predominantly molecular (H2) gas. We are just beginning to understand how the formation, properties, and destruction of these clouds varies across the universe. In this chapter, we describe how the thermal line imaging capabilities of the proposed next generation Very Large Array (ngVLA) could make major contributions to this field. Looking at CO emission, the proposed ngVLA would be able to quickly survey the bulk properties of molecular clouds across the whole nearby galaxy population. This includes many unique very nearby northern targets (e.g., Andromeda) inaccessible to ALMA. Such surveys offer a main observational constraint on the formation, destruction, lifetime, and star formation properties of clouds. Targeting specific regions, the ngVLA will also be able to heavily resolve clouds in the nearest galaxies. This will allow detailed studies of the substructure and kinematics --- and so the internal physics --- of clouds across different chemical and dynamical environments.
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