Diamond is a material with outstanding properties making it particularly suited for high added-value applications such as optical windows, power electronics, radiation detection, quantum information, bio-sensing and many others. Tremendous progresses in its synthesis by microwave plasma assisted chemical vapour deposition have allowed obtaining single crystal optical-grade material with thicknesses of up to a few millimetres. However the requirements in terms of size, purity and crystalline quality are getting more and more difficult to achieve with respect to the forecasted applications, thus pushing the synthesis method to its scientific and technological limits. In this paper, after a short description of the operating principles of the growth technique, the challenges of increasing crystal dimensions both laterally and vertically, decreasing and controlling point and extended defects as well as modulating crystal conductivity by an efficient doping will be detailed before offering some insights into ways to overcome them.