This article reviews publications with the goal of understanding the role of hydrophobic copolymers added to size-press starch as a means to make paper products more resistant to penetration by aqueous fluids. The underlying technology is considered, including background related to starch, size-press equipment, and various hydrophobic copolymers and latex products that have been evaluated. The resulting hydrophobization of the paper has been reported to depend not only on the dosage of the hydrophobic additive, but also on its molecular mass and ionic form. The mechanism appears to rely on an ability of starch to serve as a temporary host for hydrophobic compounds in aqueous solution. It has been proposed that hydrophobic copolymers added with size press starch tend to migrate to the air interface during drying of the starch film, thus allowing the low-energy functional groups, such as styrene or alkyl chains, to face outwards. Further research is needed to address various mechanistic questions. There may be opportunities to further raise the performance of this type of technology as practiced within paper production factories.