Mechanical site preparation (MSP) is deliberate soil disturbance which is undertaken to improve the conditions for forest regeneration. Disc trenching and mounding are the dominant MSP practices currently used in Sweden and Finland. In this paper, the impacts of MSP on the soil, water quality, greenhouse gas (GHG) emissions and ground vegetation of mineral soil sites in Sweden and Finland are reviewed. The practices considered are patch scarification, mounding, inverting, disc trenching, and ploughing, which together represent a wide range of soil disturbance intensity. The environmental effects of MSP in this region have not been studied extensively. The environmental impact of MSP derives from the process of creating microsites which involves horizontal and/or vertical redistribution of soil and soil mixing. This typically affects decomposition, element circulation and leaching, vegetation coverage and uptake of nutrients and water, and possibly erosion and sediment exports. Following disc trenching or mounding the effects on GHG emissions appear to be minor over the first two years. For a few years after disc trenching concentrations in soil water collected below ridges are higher than that below furrows for some elements (e.g., NO3-, NH4+, Mg2+, and total or dissolved organic C). The physical and chemical effects of ploughing remain detectable for several decades. There is little evidence about how the effects of forestry activities in upland areas on soil-water chemistry are transferred to adjacent surface water bodies, including what role streamside discharge areas play. MSP increases the tree biomass C store and may increase the total ecosystem C store. The impact of MSP on the cover and abundance of ground vegetation species depends on the composition of the original plant community, MSP intensity, and the establishment rate of different species. Species cover generally seems to decline for late succession understory species, while pioneer and ruderal species can benefit from the microsites created. Areas containing lichens which are used for reindeer forage require special consideration. More research is needed on the environmental effects of MSP, particularly regarding its long-term effects. Further efforts should be made to develop efficient site-preparation practices which better balance the disturbance intensity with what is needed for successful regeneration.