The purpose of this research was to determine the differences in empathy, alexithymia features, and theory of mind between healthy controls and patients with borderline personality disorder (BPD). Thirty-five patients with BPD and 35 healthy controls were included in the study. To measure the clinical variables, the Empathy Quotient (EQ), Reading the Mind in the Eyes Test (RMET), Toronto Alexithymia Scale (TAS-20), Barratt Impulsivity Scale-11 (BIS-11), and Beck Depression Inventory (BDI) were applied. We found that the BPD group had significantly worse total RMET and neutral RMET scores than the control group. There were no differences in the EQ scores between the BPD and control groups. The patients with BPD were more alexithymic than the controls, and alexithymia and depression scores predicted BPD status. Patients with BPD who have difficulty identifying their own emotions tend to display deficits in perceptions of facial emotions, which, in turn, may lead to misperceptions of social signals and thus contribute to excessive emotional intensity and tension in social situations. The study results reveal that alexithymia and depression are important variables in predicting BPD traits.