Abstract: Aldehydes are key volatile carbonyl compounds in alcoholic beverages, contributing to characteristic flavor formation while also being associated with potential health risks. Their effects are mainly determined by their actual concentrations and their relationship with sensory thresholds and exposure levels. Appropriate concentrations of aldehydes can contribute desirable characteristics, such as fruity, nutty, and roasted aromas, whereas excessive levels may cause undesirable sensory attributes, including irritation, oxidation-like flavors, and off-odors, while increasing potential health risks. Currently, research on aldehydes in alcoholic beverages has gradually shifted from single-component analysis to comprehensive evaluation involving multiple compounds, multiple forms, and multi-technology integration. However, challenges remain in the standardization of analytical methods, the establishment of risk assessment systems, and the development of control technologies with minimal flavor loss. Therefore, this review systematically summarizes the sources and formation mechanisms, contents, flavor contributions, and toxicological risks of representative aldehydes, including acetaldehyde, formaldehyde, acrolein, and furfural, in alcoholic beverages. The applications of analytical techniques, including gas chromatography, liquid chromatography, and mass spectrometry, for aldehyde detection are also summarized. Furthermore, strategies for reducing aldehyde-related risks, including fermentation regulation, distillation control, adsorption purification, and storage management, are discussed. This review aims to provide a reference for risk management, flavor regulation, and standardization of aldehydes in alcoholic beverages.