Psychopathy is a complex personality disorder that includes interpersonal and affective traits such as glibness, lack of empathy, guilt or remorse, shallow affect, and irresponsibility, and behavioral characteristics such as impulsivity, poor behavioral control, and promiscuity. Much is known about the assessment of psychopathy; however, relatively little isunderstood about the relevant brain disturbances. The present review integrates data from studies of behavioral and cognitive changes associated with focal brain lesions or insults and results from psychophysiology, cognitive psychology and cognitive and affective neuroscience in health and psychopathy. The review illustrates that the brain regions implicated in psychopathy include the orbital frontal cortex, insula, anterior and posterior cingulate, amygdala, parahippocampal gyrus, and anteriorsuperior temporal gyrus. The relevant functional neuroanatomy of psychopathy thus includes limbic and paralimbic structuresthat may be collectively termeddthe paralimbic systemT. The paralimbic system dysfunction model of psychopathy is discussed as it relates to the extant literature on psychopathy.