Abstract: The general issue of how gas flows into and out of galaxies has become one of the most critical problems in understanding the evolution of galaxies and their fundamental properties. New observational results based on the powerful combination of the Hubble, LBT, and Keck spectroscopy and images have constrained the mass and chemical composition of the large scale flows in and out of galaxies. These significant advances signal major progress toward answering some of the key open questions in galaxy formation studies. I will present and discuss some of these recent and exciting developments.