The older wood burning open masonry fireplace is not as common any more. They are usually very beautiful to look at and can provide a wonderful ambience, but they are terribly inefficient. The masonry construction can be clad in a variety of materials but they must be non-combustible. You can add doors to seal the fireplace opening and bring outside air into the firebox to increase efficiency. The full masonry fireplace does require a large concrete footing and foundation to support the weight of the fireplace and chimney.
A more efficient type of wood burning fireplace would be a manufactured, sealed, high efficiency unit. This could be an insert type that fits into an existing masonry fireplace or a zero clearance unit that is framed with lumber. This type of fireplace can burn very efficiently and does not require the large masonry foundation to support it. The options to decorate are much more varied, as combustible materials are not as restricted near the fireplace. With the addition of air circulation fans the fireplace can become the main source of heat for the home.