Animal studies indicate that viscous, soluble fibres such as psyllium, oat gum, guar gum and pectin have substantial hypocholesterolemic effects. Epidemiologic data suggest that the intake of complex carbohydrate and dietary fibre is associated in an inverse manner to risk for coronary artery disease (CAD). Two long term clinical trials indicate that increasing soluble fibre intake as part of a low fat, low cholesterol diet reduces serum cholesterol concentration from 3 to 5% below that for the low fat, low cholesterol diet. Short term, controlled clinical trials indicate that oat bran or beans, in a metabolic ward setting, decrease serum cholesterol concentrations of hypercholesterolemic individuals by 10 to 12%. Studies of free-living hypercholesterolemic individuals document that incorporation of oat products, psyllium or guar gum into the diet decreases serum cholesterol by 6 to 8%. Other studies suggest that increased fibre intake may decrease blood pressure slightly, assist in weight management, alter blood clotting factors, and increase insulin sensitivity. Intake of dietary fibre and complex carbohydrate appear to have a protective role for CAD. Further controlled clinical trials are required to examine the role of fibre and complex carbohydrate in prevention or regression of CAD.