Flocculation is prerequisite for bulk sedimentation of yeast during brewery fermentation. Although single yeast cells gradually sediment in green beer, this sedimentation rate is too slow without formation of large yeast flocs. The present review concerns the major determinants of yeast flocculation and sedimentation in brewery fermentations. Flocculation characteristics of yeast are strongly strain-dependent and largely defined by which FLO genes are functional in each strain. In addition to the genetic background, several environmental factors affect flocculation. These can be, somewhat arbitrarily, classified as physiological factors, such as the calcium availability, pH, temperature and ethanol and oxygen concentrations in the medium or physical factors, such as cell surface hydrophobicity, cell surface charge and the presence of appropriate hydrodynamic conditions for the formation of large flocs. Once yeast flocs are formed, their size, shape and density and the properties of the surrounding medium affect the rate at which the flocs sediment. Higher gravity worts usually result in green beers with higher viscosity and density, which both retard sedimentation. Moreover, environmental factors during yeast handling before fermentation, e.g., propagation, storage and cropping, influence the flocculation potential of yeast in subsequent fermentation. Premature yeast flocculation (PYF) and the role of PYF factors are discussed. In conclusion, some potential options available to adjust yeast flocculation are described.