Binge drinking is a widespread alcohol consumption pattern commonly engaged by youth. Here, we present the first systematic review of emotional processes in relation to binge drinking. Capitalizing on a theoretical model describing three emotional processing steps (emotional appraisal/identification, emotional response, emotional regulation) and following PRISMA guidelines, we considered all identified human studies exploring emotional abilities among binge drinkers. A literature search was conducted in PubMed, Scopus, and PsychINFO, and a standardized methodological quality assessment was performed for each study. The main findings offered by the 43 studies included are, 1) regarding emotional appraisal/identification, binge drinking is related to heightened negative emotional states, including greater severity of depressive and anxiety symptoms, and have difficulties in recognizing emotional cues expressed by others; 2) regarding emotional response, binge drinkers exhibit diminished emotional response compared with non-binge drinkers; 3) regarding emotional regulation, no experimental data currently support impaired emotion regulation in binge drinking. Variability in the identification and measurement of binge drinking habits across studies limits conclusions. Nevertheless, current findings establish the relevance of emotional processes in binge drinking and set the stage for new research perspectives to identify the nature and extent of emotional impairments in the onset and maintenance of excessive alcohol use.