Electronic packaging design is a process that requires optimized solutions based on multidisciplinary design tradeoffs, which usually have complicated relations among multiple design variables. Required numerical analyses such as thermal and thermo-mechanical have hampered this multidisciplinary optimization process because of their time intensive modeling and computation time. This paper presents a state-of-the-art overview of recent multidisciplinary design and optimization methodologies in electronics packaging. The reported methodologies are divided into tow groups: (1) integrated multidisciplinary CAD environment, and (2) automated design and optimization techniques. A semi-automated design environment, which includes graphical user interface, modeling, and simulation, enhances the design procedure in the first group. Fully automated design optimization methodologies are used for various design applications in the second group. In recent years, methodologies using (1) detailed numerical analysis models directly connected to optimization algorithms, (2) design of experiments (DoE), and (3) artificial neural networks (ANNs) have been proposed as new trends in this field. Advantages as well as disadvantages of these methods are discussed.