This review discusses conceptual issues in relating temperament to psychopathology, including the disputed relation of temperament to personality in children. A potential integrative framework is discussed that links trait and biological markers of temperament (reactive, incentive–response tendencies) with regulatory processes. This framework is utilized to highlight potential temperamental pathways to specific forms of psychopathology, noting that in some instances their relations may reflect a spectrum model (with psychopathology closely related as an extreme of a temperament-based trait), but in many instances it likely reflects a vulnerability-transaction set of processes. Conduct disorder involves at least two temperamental paths, one emanating from low fear response and one from either high incentive approach or high anger reactivity. Attention deficit hyperactivity disorder also involves at least two temperament pathways, one involving extremely low effortful control and the other likely involving strong approach. Anxiety disorders appear to result from the confluence of high negative emotionality and low effortful control. Hypotheses for future research are presented and limitations discussed.