We review current research related to spectroscopy of gamma-ray burst (GRB) after-glows with particular emphasis on the interstellar medium (ISM) of the galaxies hosting these high redshift events. These studies reveal the physical conditions of star-forming galaxies and yield clues to the nature of the GRB progenitor. We offer a pedagogical review of the experimental design and review current results. The majority of sightlines are characterized by large HI column densities, negligible molecular fraction, the ubiquitous detection of UV pumped fine-structure transitions, and metallicities ranging from 1/100 to nearly solar abundance.