The use of first-row transition metals for the catalytic reduction of carbonyl functionalities has become increasingly important in homogeneous catalysis. This Perspective examines the mechanistic aspects of these reduction reactions, with a focus on various interactions between metal complexes and substrates. Four different types of catalytic pathways, namely catalysis with dihydride (or dihydrogen) complexes, catalysis with monohydride complexes, metal–ligand bifunctional catalysis, and catalysis involving ionic mechanisms, are discussed with recent examples highlighted.