Molecular plasmonics, the area which deals with the interactions between surface plasmons and molecules, has received enormous interest in fundamental research and found numerous technological applications. Plasmonic metamaterials, which offer rich opportunities to control the light intensity, field polarization, and local density of electromagnetic states on subwavelength scales, provide a versatile platform to enhance and tune light-molecule interactions. A variety of applications, including spontaneous emission enhancement, optical modulation, optical sensing, and photoactuated nanochemistry, have been reported by exploiting molecular interactions with plasmonic metamaterials. In this paper, we provide a comprehensive overview of the developments of molecular plasmonics with metamaterials. After a brief introduction to the optical properties of plasmonic metamaterials and relevant fabrication approaches, we discuss light-molecule interactions in plasmonic metamaterials in both weak and strong coupling regimes. We then highlight the exploitation of molecules in metamaterials for applications ranging from emission control and optical modulation to optical sensing. The role of hot carriers generated in metamaterials for nanochemistry is also discussed. Perspectives on the future development of molecular plasmonics with metamaterials conclude the review. The use of molecules in combination with designer metamaterials provides a rich playground both to actively control metamaterials using molecular interactions and, in turn, to use metamaterials to control molecular processes.