Cardiovascular disease (CVD) is the leading cause of death in most developed countries. Most CVD deaths are preventable through life-style measures such as diet, exercise and avoidance of cigarette smoking. Decreased intake of saturated fat and cholesterol and increased intake of cholesterol-reducing foods, such as pulses, deserve a high priority for activities designed to prevent CVD. Epidemiological and observational studies indicate that habitual intakes of large amounts of dietary fibre or of vegetables are associated with significantly lower rates of CVD. Studies over four decades document the hypocholesterolaemic effect of pulses and soyabeans. We performed a meta-analysis of eleven clinical trials that examined the effects of pulses (not including soyabeans) on serum lipoproteins. Intake of non-soya pulses was associated with these changes: fasting serum cholesterol, –7·2%, 95% CI –5·8, –8·6%; LDL–cholesterol, –6·2%, 95% CI –2·8, –9·5%; HDL–cholesterol, +2·6%, 95% CI +6·3, –1·0%; triacylglycerols, –16·6 %, 95% CI –11·8 %, –21·5 %; and body weight, –20·9%, 95% CI +2·2%, –4·1%. The hypocholesterolaemic effects of pulses appear related, in estimated order of importance, to these factors: soluble dietary fibre, vegetable protein, oligosaccharides, isoflavones, phospholipids and fatty acids, saponins and other factors. Intake of pulses may also reduce risk for CVD by favourable effects on blood pressure, glycaemia and risk for diabetes, and risk for obesity. Overall, the available evidence indicates that regular consumption of pulses may have important protective effects on risk for CVD.