Alexithymia is a personality construct typified by a difficulty in identify, express, or describe emotions; inability to discriminate between feelings and physical sensations; and an externally oriented thinking style. It is a multifaceted construct, characterized by impairments in emotional awareness, connected to several dimensions of alcohol use disorders or misuse. Its role in heavy and problematic alcohol consumption is well documented. Alexithymia has been linked to risky or problematic alcohol use. The literature shows high prevalence of alexithymia in alcohol misuse or alcohol use disorder and its association with several drinking constructs such as craving, which plays an important role in theoretical and clinical models regarding the development, maintenance, and reinstatement of AUDs. The high rates of alexithymia among individuals with alcohol use disorders and the therapeutic challenge that alexithymia represents indicate the negative influence of alexithymia on treatment outcomes in patients with AUD.