Some languages (e. g. Sanskrit and Classical Greek) have a 'middle voice'. An intransitive verb that appears active but expresses a passive action characterizes the English middle voice. For example, in The casserole cooked in the oven, cooked is syntactically active but semantically passive, putting it in the middle voice. In Classical Greek, the middle voice is often reflexive, denoting that the subject acts on or for itself, such as “The boy washes himself.” or “The boy washes.” It can be transitive or intransitive. It can occasionally be used in a causative sense, such as “The father causes his son to be set free.” or “The father ransoms his son.”

Many deponent verbs in Latin are also survivals of the Indo-European middle voice; many of these in turn survive as obligatory pseudo-reflexive verbs in the Romance languages such as French and Spanish.

Some languages have even more grammatical voices. For example, in Classic Mongolian language there are five voices: active, passive, causative, reciprocal and cooperative.

Ergative languages usually do not have a passive voice, since their syntactic structure does not agree with it; instead some have an antipassive voice that deletes the object of transitive verbs.