Excited state contributions represent a formidable challenge for hadron structure calculations in lattice QCD. For physical systems that exhibit an exponential signal-to-noise problem they often hinder the extraction of ground state matrix elements, introducing a major source of systematic error in lattice calculations of such quantities. The development of methods to treat the contribution of excited states and the current status of related lattice studies are reviewed with focus on nucleon structure calculations that are notoriously affected by excited state contamination.