Nucleotide-binding and oligomerization domain (NOD)-like receptors (NLRs) are cytosolic pattern-recognition receptors that sense microbial invasion, cell stress and physiological perturbations, and elicit an inflammatory response to alert the system to the presence of danger. Most NLRs exert their functions by assembling inflammasomes that recruit and activate caspase-1, whereas a few engage the NFκB and MAPK pathways. In the past few years, significant insights have been gained into the regulatory mechanisms of these innate immunity effectors and their role in health and disease that, notably, have led to direct therapeutic applications in the clinic. This review discusses the biology of NLRs, focusing on recent advances in the field that indicate a broader role for these proteins than had been previously anticipated, such as in priming systemic innate immunity, driving adaptive immunity, maintaining tissue homeostasis and inducing tissue repair following injury.