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The perinatal period, which covers the time when a man’s partner becomes pregnant through to the first year after birth can be a time of great excitement, happiness, and joy. However, it can also be a time of great disruption and change. Despite the positive and protective long-term effect that fatherhood has on men’s health, a significant proportion of fathers’ experience depressive symptoms during the perinatal period. This paper aims to review studies that assessed symptoms of depression in fathers during the perinatal period and to describe the prevalence estimates, identify the risk factors and impact of depression, and establish if there are interventions that effectively reduce depression among fathers. A systematic search of relevant electronic databases including Medline, CINAHL, Cochrane Library, PsycARTICLES, PsycINFO, and Psychology and Behavioural Sciences Collection were searched using keywords related to paternal perinatal depression. Prevalence estimates of paternal perinatal depression varied widely between studies, ranging from 1 to 46%. Several sociodemographic variables that contribute to depression in fathers in the perinatal period were reported and these include paternal age, lower education levels, parity, an unplanned pregnancy, and maternal depression. Paternal perinatal depression is associated with morbidity within the father’s family, including depression in his partner, maladjustment to parenthood and future psychological problems in his children. In conclusion, evidence from this review adds further support for the need to review how we plan, provide and resource our health services, to recognize the influence that pregnancy, birth, and fatherhood in the perinatal period can have on men’s mental health.