Recent developments of generative artificial intelligence (AI) have gained significant interest in research and practice and are expected to profoundly transform the media landscape. Among new AI technologies, deepfakes—hyper-realistic, AI-generated media—stand out for their significant impacts. This chapter provides a comprehensive reflection of the emergence of deepfakes, their opportunities and risks across multiple areas as well as the state of research on the phenomenon. It provides an overview of deepfakes from a communication and media studies perspective, combining a conceptual examination of the technology’s further development with empirical findings from 5 years of the authors’ research. Drawing on original studies, this chapter discusses the role of deepfakes in the context of AI inequalities by focusing on Internet users’ knowledge and attitudes toward the phenomenon and highlighting gender-related differences. Furthermore, it investigates the impacts of the technology for journalistic practice by discussing changing routines and the need for guidelines in order to exploit the potential for innovation of the technology while maintaining journalistic norms, the audiences’ trust, and mitigating harmful uses of the technology. Finally, this chapter discusses a multidimensional framework for future research, emphasizing the need to address deepfakes across an individual, organizational, and sociopolitical level. The rise of the novel technology calls for an integrative approach that considers (ethical) regulations, technological solutions, and audience-centered perspective in order to responsibly shape communication in the age of synthetic realities.