Often blamed for bringing green aromas and astringency to wines, the use of stems is also empirically known to improve the aromatic complexity and freshness of some wines. Although applied in different wine-growing regions, stems use remains mainly experimental at a cellar level. Few studies have specifically focused on the compounds extracted from stems during fermentation and maceration and their potential impact on the must and wine matrices. We identified current knowledge on stem chemical composition and inventoried the compounds likely to be released during maceration to consider their theoretical impact. In addition, we investigated existing studies that examined the impact of either single stems or whole clusters on the wine quality. Many parameters influence stems’ effect on the wine, especially grape variety, stem state, how stems are incorporated, when they are added, and contact duration. Other rarely considered factors may also have an impact, including vintage and ripening conditions, which could affect the lignification of the stem.