In this study, a total of 108 Aphidiinae species, belonging to 18 genera, associated with 240 aphid species in 16 countries of the Middle East and North Africa are reviewed. 743 host aphid-parasitoid associations are listed. New material was collected from various regions of Saudi Arabia during 2011–2013. Three species including Aphidius avenae Haliday, 1834, Aphidius platensis Brèthes, 1913 and Praon barbatum Mackauer, 1967 are first recorded for the fauna of this country. Lysiphlebus marismortui Mescheloff & Rosen, 1990 syn. nov. is classified as the junior synonym of Lysiphlebus confusus Tremblay & Eady, 1978. An illustrated up-to-date key to all known species of Aphidiinae that occur in the Middle East and North Africa is provided. The findings are discussed in relation to the overall parasitoid-aphid associations in the target investigated region.