Biological systems across various length and time scales are noisy, including tissues. Why are biological tissues inherently chaotic? Does heterogeneity play a role in determining the physiology and pathology of tissues? How do physical and biochemical heterogeneity crosstalk to dictate tissue function? In this review, we begin with a brief primer on heterogeneity in biological tissues. Then, we take examples from recent literature indicating functional relevance of biochemical and physical heterogeneity and discuss the impact of heterogeneity on tissue function and pathology. We take specific examples from studies on epithelial tissues to discuss the potential role of inherent tissue heterogeneity in tumorigenesis.