Raman optical activity measures vibrational optical activity by means of a small difference in the intensity of Raman scattering from chiral molecules in right and left circularly polarized incident light. The sensitivity of ROA to chirality makes it an incisive probe of biomolecular structure and dynamics in aqueous solution. This article reviews the basic theory and instrumentation of ROA, and describes recent results which illustrate how ROA provides new insight into current biomedical problems including protein misfolding and disease, and virus structure at the molecular level.