There is a wealth of empirical data pertaining to the issue of neuropsychological impairment in depression. However, a coherent and comprehensive framework for understanding the disorder remains elusive. This review will briefly consider some of the important issues on which recent research has focused. It would be premature to derive firm conclusions in an area characterized by considerable confusion, so the aim of this review is to highlight the key areas that must be addressed, Three distinct questions are considered. The first concerns the neuropsychological specificity of the deficits associated with depression; whether they represent selective deficits or a more general profile of impairment, The second question is to determine how cognitive deficits might relate to clinical and demographic factors, including symptom severity, hospitalization, medication and ageing, Finally, a comprehensive theory of depression must also relate impairments to neuropathology, and evidence is now available from imaging studies that have attempted to elucidate neural substrates of neuropsychological deficits.