The role of saturated fat (SFA) in health is frequently debated. Guidelines from different countries are quite comparable, in that they generally advise people to avoid high intakes of SFA and to replace some saturated fats by cis unsaturated fats. A maximum level of intake of 10% energy of SFA (of total energy) is often advised as a guideline for the general population. This paper discusses issues around SFA and health including the pros and cons of randomised controlled trials with hard endpoints, prospective cohort studies and controlled dietary intervention studies with intermediate endpoints and risk markers, concluding that there is not a single kind of research study that will answer the question on whether intake of saturated fat influences health or not. However, taking all the evidence together suggests that replacing SFA by unsaturated fat, preferably polyunsaturated fat (PUFA), to an intake below 10% energy will favourably affect the risk of cardiovascular disease. It is important to take into account that the proposed changes should be implemented in an otherwise healthy and complete diet. To reach an intake of less than 10% energy from SFA without compromising on the quality of the total diet, the intake of fatty meat and baked goods such as cakes and pastries should be reduced and butter, lard and hard baking fats should be replaced by unsaturated oils and fat spreads made from them.