The northeastern part of the North Atlantic is unique in the sense that it is much warmer in the surface than other ocean areas at similar latitudes. The main reason for this is the large northward transport of heat that extends to high latitudes and crosses the Greenland-Scotland Ridge to enter the Nordic Seas and the Arctic. There the warm Atlantic water is converted to colder water masses that return southwards over the ridge partly as surface outflows and partly as overflows through the deep passages across the ridge. In this paper, the state of knowledge on the exchanges especially across the eastern part of the Greenland-Scotland Ridge is reviewed based on results from the ICES NANSEN (North Atlantic-Norwegian Sea Exchanges) project, from the Nordic WOCE project and from other sources. The accumulated evidence allows us to describe the exchanges in fair detail; the origins of the waters, the patterns of their flow towards and over the ridge and their ultimate fate. There is also increasing information on temporal variations of the exchanges although dynamical changes are still not well understood. Quantitative estimates for the volume transport of most of the overflow branches seem reasonably well established, and transport measurements of the Atlantic inflows to the Nordic Seas are approaching acceptable levels of confidence which allows preliminary budgets to be presented. The deep overflows are driven by pressure gradients set up by the formation of deep and intermediate water. The dominance of deep overflows over surface outflows in the water budget argues that this thermohaline forcing also dominates over direct wind stress and estuarine forcing in driving the Atlantic water inflow across the Greenland-Scotland Ridge, while wind stress seems to influence the characteristics and distribution of the Atlantic water north of the ridge.