Database tuning is the process of optimizing a database to maximize performance. It involves activities like configuring disks, tuning SQL statements, and sizing memory properly. Database performance issues commonly stem from slow physical I/O, excessive CPU usage, or latch contention. Tuning opportunities exist at the level of database design, application code, memory settings, disk I/O, and eliminating contention. Performance monitoring tools like the Automatic Workload Repository and wait events help identify problem areas.