Since the first description by Lhermitte (1983), the utilization behavior (UB) still represents an enigma for behavioral neurology and neuropsychology. Recent findings shed some light on new frameworks for interpreting this interesting phenomenon. Functional neuroanatomical basis is still unclear, although recent advances in neuroimaging techniques have contributed to a better understanding of the syndrome. An important and promising step is given by shifting researcher's attention from frontoparietal to intrafrontal mechanisms. From a cognitive standpoint, three models have been proposed. However, a comprehensive account for the UB neurobehavioral complexity is still lacking. Aims of this paper are to briefly review the reported cases of utilization behavior (UB) and to describe the putative neurological mechanisms underlying UB. Furthermore, the cognitive models proposed to interpret UB will be summarized. For clinical purposes, features suitable for distinguishing UB from other neurobehavioral symptoms will be briefly described.