This article reviews the role of molecular gas and star formation on cloud scales in nearby galaxies. It discusses how observations of nearby galaxies at high resolution reveal the properties of molecular clouds, star formation efficiencies, and the impact of stellar feedback. The study finds that molecular gas surface density, line width, and internal pressure reflect the large-scale galactic environment and are consistent with a turbulent medium affected by self-gravity. Cloud-scale data allows for statistical inference of evolutionary and physical timescales, suggesting a cloud collapse period of order the free-fall or turbulent crossing time (10-30 Myr) followed by rapid gas clearing after star formation begins. The star formation efficiency per free-fall time is well determined at ~0.5% over thousands of regions. Stellar feedback is measured using multiple observational approaches, with the net yield constrained by the need to support the vertical weight of the galaxy disk. Short gas clearing timescales suggest a large role for pre-supernova feedback in cloud disruption. Supernovae then exert a large influence on the galaxy, stirring turbulence, launching galactic-scale winds, and carving superbubbles. The article also discusses galaxy centers, the most accessible extreme environment for cloud-scale studies, and highlights the importance of cloud-scale observations in understanding the star formation process and its feedback mechanisms. The review emphasizes the need for further studies to understand the variations in star formation efficiency and the role of stellar feedback in shaping the interstellar medium.This article reviews the role of molecular gas and star formation on cloud scales in nearby galaxies. It discusses how observations of nearby galaxies at high resolution reveal the properties of molecular clouds, star formation efficiencies, and the impact of stellar feedback. The study finds that molecular gas surface density, line width, and internal pressure reflect the large-scale galactic environment and are consistent with a turbulent medium affected by self-gravity. Cloud-scale data allows for statistical inference of evolutionary and physical timescales, suggesting a cloud collapse period of order the free-fall or turbulent crossing time (10-30 Myr) followed by rapid gas clearing after star formation begins. The star formation efficiency per free-fall time is well determined at ~0.5% over thousands of regions. Stellar feedback is measured using multiple observational approaches, with the net yield constrained by the need to support the vertical weight of the galaxy disk. Short gas clearing timescales suggest a large role for pre-supernova feedback in cloud disruption. Supernovae then exert a large influence on the galaxy, stirring turbulence, launching galactic-scale winds, and carving superbubbles. The article also discusses galaxy centers, the most accessible extreme environment for cloud-scale studies, and highlights the importance of cloud-scale observations in understanding the star formation process and its feedback mechanisms. The review emphasizes the need for further studies to understand the variations in star formation efficiency and the role of stellar feedback in shaping the interstellar medium.