Over the past twenty years research interest has been focused on deepening the role of parental mentalizing. Nevertheless, few studies have specifically addressed the role played by fathers’ mentalizing. This systematic review aims to bridge this gap by offering an exploration of paternal mentalizing within attachment theory considering three different operationalizations: Reflective Functioning, Parental Insightfulness and Mind-Mindedness. Starting from this, the main goals of this systematic review are: (1) to show the effect of paternal mentalizing on child’s outcomes or paternal role within the family system, (2) to increase research exchange between different theoretical frameworks, enhancing the knowledge of the mentalization construct, (3) to explore under-researched areas and implications for research and clinical practice. PsycInfo, PsycArticle, Web Of Science, Scopus, Medline, PubMed and EMBASE were systematically searched for articles published until February 7, 2021. In total, 6311 studies were considered for the systematic review; of these, thirty-six met the inclusion criteria. The included studies were subsequently split on the basis of the specific mentalizing operationalization. Overall, the data showed significant associations between paternal mentalizing and both fathers’ parenting features and variables related to the paternal broader functioning within the family context. This systematic review also confirms the role of fathers’ mentalizing processes in relation to paternal features and child’s outcomes. In conclusion, further studies aimed at examining paternal mentalizing specific influences, exploring the causal pathways related to paternal mentalizing and investigating the relationship between different mentalizing dimensions and their diverse effects are recommended.