Temperaments are permanent variations of personality, traits and ways of reacting that characterize individuals and remain constant throughout several diverse situations. Temperaments play a crucial role in determining emotional reactions, therefore several temperamental models attempted to establish relationship between temperaments and affective disorders. According to the model of Akiskal, affective temperaments are subclinical and subaffective trait-like manifestations of affective disorders. Unlike several models of temperament which were developed theoretically in order to describe healthy human functioning, and were later extrapolated to also capture the pathological domains of mental and behavioral features, the model of affective temperaments was developed on Kraepelinian and Kretschmerian traditions and based on the observation of patients with mood disorders and their healthy first degree relatives and from that point broadened to encompass also the subclinical and nonclinical domains of affective reactivity. There is accumulating evidence concerning the development of affective temperaments based on their adaptive evolutionary characteristics and genetic background, and normative data from large national studies on general and healthy samples indicate their universal characteristics. Studies in affective patient populations indicate that the relationship between affective temperaments and affective illness is more complex than a simple extrapolation from psychopathology and mental health, and affective temperaments may play a patoplastic role in mood disorders determining their evolution, clinical features, main characteristics and outcome. A large body of data on affective temperaments has been published during the last decade, deserving a critical analysis presented in this review.