Background: Muslims fast from sunrise to sunset during the month of Ramadan, the 9th lunar month. The duration of fasting varies from 13 to 18 h/day. Fasting includes avoidance of drinking liquids and eating foods. The aim of this article is to review health-related aspects of Ramadan fasting. Methods: Related abstracts from 1960 to 2009 were obtained from Medline and local journals in Islamic countries. One hundred and thirteen articles meeting the criteria for paper selection were reviewed in depth to identify details of related materials. Results: During the fasting days of Ramadan glucose homeostasis is maintained by meals taken before dawn and by liver glycogen stores. Changes in serum lipids are variable and depend on the quality and quantity of food consumption and changes in weight. Compliant, well-controlled type 2 diabetics may observe Ramadan fasting, but fasting is not recommended for type 1, noncompliant, poorly controlled and pregnant diabetics. There are no adverse effects of Ramadan fasting on the heart, lung, liver, kidney, eyes, hematologic profile, endocrine and neuropsychiatric functions. Conclusions: Although Ramadan fasting is safe for all healthy individuals, those with various diseases should consult their physicians and follow scientific recommendations.