More than a decade after the discovery of MXene, there has been a remarkable increase in research on synthesis, characterization, and applications of this growing family of two-dimensional (2D) carbides and nitrides. Today, these materials include one, two, or more transition metals arranged in chemically ordered or disordered structures of three, five, seven, or nine atomic layers, with a surface chemistry characterized by surface terminations. By combining M, X, and various surface terminations, it appears that a virtually endless number of MXenes is possible. However, for the design and discovery of structures and compositions beyond current MXenes, one needs suitable (stable) precursors, an assessment of viable pathways for 3D to 2D conversion, and utilization or development of corresponding synthesis techniques. Here, we present a critical and forward-looking review of the field of atomic scale design and synthesis of MXenes and their parent materials. We discuss theoretical methods for predicting MXene precursors and for assessing whether they are chemically exfoliable. We also summarize current experimental methods for realizing the predicted materials, listing all verified MXenes to date, and outline research directions that will improve the fundamental understanding of MXene processing, enabling atomic scale design of future 2D materials, for emerging technologies.