The fatigue mechanics and mechanisms of cemented carbides (composites usually referred to as hardmetals) are reviewed. The influence of microstructure on strength lessening and subcritical crack growth for these ceramic-metal materials when subjected to cyclic loads are highlighted. The simultaneous role of the ductile metallic binder as a toughening and fatigue-susceptible agent for hardmetals results in a tradeoff between properties measured under monotonic and cyclic loading: fracture strength and toughness on one hand, as compared to fatigue strength and crack growth resistance on the other one. Toughness/fatigue–microstructure correlations are analyzed and rationalized on the basis of specific crack–microstructure interactions, documented by the effective implementation of advanced characterization techniques. As a result, it is concluded that the fatigue sensitivity of cemented carbides may be reduced if either toughening mechanisms beyond ductile ligament bridging, such as crack deflection, are operative, or strain localization within the binder is suppressed. In this regard, grades exhibiting metallic binders of a complex chemical nature and/or distinct microstructural assemblages are proposed as options for effective microstructural tailoring of these materials.