Adverse changes in postprandial metabolism may promote the development of cardiovascular disease (CVD) through a range of mechanisms. Since a large proportion of our day is spent in the postprandial state it is important to understand these post meal changes with respect to both the amount and type of nutrient consumed. Of particular importance appear to be the fatty meals, commonly eaten and which can induce significant postprandial lipaemia, accumulation of potentially atherogenic triglyceride-rich lipoprotein (TRL) remnants and formation of highly oxidisable small, dense low-density lipoproteins (LDL). In addition to these relatively well established lipaemic effects there is growing evidence that high-fat foods also have adverse effects on a number of the emerging CVD risk factors including haemostasis, mediators of inflammation and endothelial function. This review will consider the acute effects of high-fat feeding, investigating any differential effects of saturated and unsaturated fatty acids, on postprandial lipaemic profile, haemostatic clotting factors fibrinogen and factor VII, acute phase C-reactive protein (C-RP), inflammatory cytokines interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α), and vascular reactivity.