The summarizing paper deals with the structure and biological effects of saponins generally and in relation with the treatment and prevention of diseases of the heart and circulatory system. In this field, mainly the saponins from the plants of the genera Panax, Gynostemma or Bupleurum are of use. Also soya saponins and saponins of the genera Astragalus, Salvia, Boussigaultia and Litchi can be employed. Saponins exert a positive effect on the function of the heart direct, or they help treat related diseases. For instance, they inhibit the formation of lipid peroxides in the cardiac muscle or in the liver, they influence the function of enzymes contained in them, they decrease blood coagulation, cholesterol and sugar levels in blood, they stimulate the immunity system. They act either direct, blocking the transfer of Ca2+ ions or modulating the function of Na(+)-K(+)-ATPase, or they help resorb other active principles. It can be concluded that saponins are a prospective group of drugs of natural origin for the prevention and treatment of diseases of the heart and circulatory system.