Litter decomposition is a key driver of ecosystem processes and carbon cycling. Decomposition rate is influenced by numerous factors, such as temperature, humidity, litter properties, soil properties, and properties of soil fauna/microbial communities. The aim of this review was to summarize current knowledge on litter decomposition above the treeline in alpine regions worldwide and identify: I) factors that have been studied in great detail, II) factors that have been less intensively investigated, III) geographical regions that have been less well studied, and IV) factors with consistent or inconsistent effects on decomposition. The review showed inconsistent results for all factors covered by two or more studies regarding their effect on decomposition rate (positive, negative, no effect), usually a result of interactions between factors. Studies examining one or several factors in the physical environment (i.e., altitude, experimental warming, microclimate, snow cover and soil moisture) were most common, while studies on different aspects of resource quality were the second most common. The impacts of trophic interactions on soil microbes and fauna were less frequently studied. Europe and Asia were the best-represented regions, in terms of number of studies and geographical distribution, while there were no studies from Africa and very few from South America and Australia. North American studies were all from Colorado, and those from Asia were all from China. In order to obtain better global representation, there is a need for studies in Africa, South America, and Australia. There is also a need for more studies to explain the large variation in responses of litter decomposition rates to different influencing factors in alpine environments. Future research should focus on interactions between different factors and on experiments testing specific relationships, such as the potential interaction between temperature and soil moisture and its effect on litter decomposition above the treeline in alpine regions.