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A healthy diet and a healthy lifestyle reduces cardiovascular risk. \u2018Functional foods\u2019 supplemented with phytosterols are recommended for the management of hypercholesterolaemia and have become a widely used non\u2010prescription approach to lower plasma cholesterol levels. Two billion euros are spent world\u2010wide each year on various functional foods, which have regulator\u2010approved health claims for the management of elevated cholesterol levels. While international societies, such as the European Atherosclerosis Society or the National Heart Foundation in Australia, still advise phytosterols as an additional dietary option in the management of hypercholesterolaemia, recently released guidelines such as those from the National Institute of Health and Clinical Excellence in the United Kingdom are more critical of food supplementation with phytosterols and draw attention to significant safety issues. This review challenges whether an intervention with phytosterol supplements is beneficial. We summarize the current evidence from genetic diseases, genetic association studies, clinical trial data and data from animal studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Linked Articles<\/jats:title><jats:p>This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. 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