Chronic fatigue syndrome (CFS) is characterised by severe fatigue and is associated with functional impairment. Somatic symptoms are often present. Although much debate exists about the aetiology of CFS, misinterpretations in the cognitive processing of emotions has been suggested as a causal factor in vulnerable individuals. The rehabilitative treatments of cognitive behavioural therapy and graded exercise therapy have been shown to be effective in improving fatigue and disability in CFS. To date these are the only evidence-based treatments, but effect sizes are modest. Some patients may benefit from receiving more emotion-focused treatments once their functioning has improved. The aim of this paper is to explore the literature on emotional expression and processing in the context of CFS.