At sites with either peat or mineral soils in large areas of boreal forests, high soil-water contents hamper tree growth and drainage can significantly increase growth. Hence, areas covering about 15 × 106 ha of northern peatlands and wet mineral soils have been drained for forestry purposes. Usually ditches gradually deteriorate, thus reducing their functionality as drains, and ditch-network maintenance (DNM) might be needed to maintain stand growth rates enabled by the original ditching. This article reviews current knowledge on establishing the need for DNM in boreal forest stands, subsequent growth responses, and the financial outcome of the activity. The issues covered in the review are: (i) ditching, changes in ditches over time and the need for DNM; (ii) interactions between soil water and both stand properties and stand management; (iii) ground-water level (GWL) and tree growth responses to DNM; and (iv) financial viability of DNM. Conclusions about the current understanding of issues related to DNM are drawn and implications for DNM in practice are summarized. Finally, gaps in knowledge are identified and research needs are suggested.