There is a general perception that fat intake increases cardiovascular (CV) risk. We review the literature regarding the consumption of a high fat food, nuts, and CV risk. We also review the effect of metabolic studies relating dietary intervention with nuts and the effect of this intervention on established CV risk factors, especially low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol and weight. The consumption of nuts is associated with a marked 40%-50% decrease in CV risk in large population based studies. Nut consumption is also associated with clinically relevant reduction in LDL cholesterol (-9% to -16%) without adversely affecting HDL cholesterol or causing a significant amount of weight gain.