We here assess limbic and orbitofrontal control in 20 patients with essential tremor (ET) and 18 age-matched healthy controls using the Ekman Facial Emotion Recognition Task and the IOWA Gambling Task. Our results show an inverse relation between facial emotion recognition and tremor severity. ET patients also showed worse performance in joy and fear recognition, as well as subtle abnormalities in risk detection, but these differences did not reach significance after correction for multiple testing.