The document summarizes some of the key changes in Drupal 7 theming compared to Drupal 6. Some of the main changes include improved core themes, a new Appearance page for configuring themes, cleaner template files with renamed variables, additional regions and blocks, and a new theme hook suggestion system to allow for more granular theming control. The document also notes that fields, image handling, and preprocess functions remain very similar to Drupal 6.