Wave energy is among the many renewable energy technologies being researched and developed to address the increasing demand for low-emissions energy. The unique design challenges for wave energy converter design—integrating complex and uncertain technological, economic, and ecological systems, overcoming the structural challenges of ocean deployment, and dealing with complex system dynamics—have lead to a disjointed progression of research and development. There is no common design practice across the wave energy industry and there is no published synthesis of the practices that are used by developers. In this paper, we summarize the methods being employed in WEC design as well as promising methods that have yet to be applied. We contextualize these methods within an overarching design process. We present results from a survey of WEC developers to identify methods that are common in industry. From the review and survey results, we conclude that the most common methods of WEC design are iterative methods in which design parameters are defined, evaluated, and then changed based on evaluation results. This leaves a significant space for improvement of methods that help designers make better-informed decisions prior to sophisticated evaluation, and methods of using the evaluation results to make better design decisions during iteration. Despite the popularity of optimization methods in academic research, they are less common in industry development. We end this paper with a summary of the areas of WEC design in which the testing and development of new methods is necessary, and where more research is required to fully understand the influence of design decisions on WEC performance.