This review summarizes the abundant literature on food-borne heterocyclic amines, their chemistry and formation, their occurrence in food, their biological activities including mutagenicity, induction of DNA damage and carcinogenicity. Pharmacokinetics and biotransformation are also discussed. Factors that influence these effects are given consideration, with special emphasis on dietary factors that might counteract detrimental biological effects. The annual per capita intake of heterocyclic amines via food is estimated. Risk extrapolations that have been published suggest that food-borne heterocyclic amines are relevant for human cancer etiology.