The present article reviews a large number of research publications on the effect of mischmetal (MM), rare earth metals (RE), La or Ce, and combinations of La + Ce on the performance of Al-Si cast alloys mainly 319, 356, 380, 413, and 390 alloys. Most of these articles focused on the use of rare earth metals as a substitute for strontium (Sr) as a eutectic silicon (Si) modifier if added in low percentage (< 1 wt.%) to avoid precipitation of a significant amount of insoluble intermetallics and hence poor mechanical properties. Other points that were considered were the affinity of RE to react with Sr., reducing its effectiveness as modifier, as well as the grain refining efficiency of the added RE in any form. None of these articles mentioned the exact composition of the RE used and percentage of tramp elements inherited from the parent ore. Using high purity La or Ce proved to have no effect on the Si shape, size or distribution, in particular at low solidification rates (thick sections). However, regardless the source of the RE, its addition to Sr-modified alloys reduced the modification effect. As for grain refining, apparently a high percentage of RE (> 1 wt.%) is required to achieve a noticeable reduction in grain size, however at the cost of alloy brittleness.