Social problems and the neglect of social relationships and activities are essential features of substance use disorders (SUDs). Recently, social impairments of individuals with specific SUD have begun to be characterized at the cognitive, emotional, and behavioral level by neuropsychological and social neuroscience methods. Growing evidence suggests that specific SUDs are associated with specific dysfunctions in social cognition and interaction, and that these impairments likely contribute to the social dysfunctions occurring in the daily life of SUD-affected people. It has also been proposed that sociocognitive deficits—such as decreased emotional empathy, worsened mental perspective-taking, and a blunted ability to perceive reward from social interactions—play a prominent role in the establishment, development, and course of therapeutic relationships, where they potentially hamper treatment success. This chapter provides a brief overview of the current status of social cognition research in SUD and discusses future directions for the assessment and treatment of social impairments in SUD.