Metabolic syndrome is a term linking the clinical profiles of some of the world’s major health problems today: obesity, heart disease and diabetes. It is predicated on dietary patterns, and particularly on the delivery of fuel. The effects may be seen first in the development of abdominal obesity and insulin resistance leading to type 2 diabetes mellitus and coronary heart disease. This review examines the role resistant starch might play in the prevention and management of these conditions. Beginning with a definition of resistant starch, a critical review of the scientific literature is presented. Current knowledge suggests that resistant starch in the diet may assist in the prevention and management of conditions associated with the Metabolic Syndrome via its potential effects on delaying the delivery of glucose as fuel with subsequent fat utilisation and appetite control benefits. There is still a great deal of research to be undertaken in this area, but it is clearly warranted given the position of starches in the global food supply and the potential impact on population health.