Nitrate and nitrites are used to give the characteristic color to cured meat products and to preserve them. According to the scientific knowledge available at the moment, these compounds are approved as food additives based on a detailed ponderation between the potential risks and benefits. The controversy over nitrites has increased with the release of an IARC Monograph suggesting an association between colorectal cancer and dietary nitrite in processed meats. The trend in “clean label” products reinforced the concern of consumers about nitrates and nitrites in meat products. This review aims to explain the role of nitrates and nitrites used in meat products. The potential chemical hazards and health risks linked to the consumption of cured meat products are described. Different strategies aiming to replace synthetic nitrate and nitrite and obtain green-label meat products are summarized, discussing their impact on various potential hazards. In the light of the present knowledge, the use or not of nitrite is highly dependent on the ponderation of two main risks—the eventual formation of nitrosamines or the eventual out-growth of severe pathogens. It is evident that synthetic nitrite and nitrate alternatives must be researched, but always considering the equilibrium that is the safety of a meat product.
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