Fuels from renewable resources have gained worldwide interest due to limited fossil oil sources and the possible reduction of atmospheric greenhouse gas. One of these fuels is so called biodiesel produced from vegetable oil by transesterification into fatty acid methyl esters (FAME). To get a first insight into changes of health hazards from diesel engine emissions (DEE) by use of biodiesel scientific studies were reviewed which compared the combustion of FAME with common diesel fuel (DF) for legally regulated and non-regulated emissions as well as for toxic effects. A total number of 62 publications on chemical analyses of DEE and 18 toxicological in vitro studies were identified meeting the criteria. In addition, a very small number of human studies and animal experiments were available. In most studies, combustion of biodiesel reduces legally regulated emissions of carbon monoxide, hydrocarbons, and particulate matter. Nitrogen oxides are regularly increased. Among the non-regulated emissions aldehydes are increased, while polycyclic aromatic hydrocarbons are lowered. Most biological in vitro assays show a stronger cytotoxicity of biodiesel exhaust and the animal experiments reveal stronger irritant effects. Both findings are possibly caused by the higher content of nitrogen oxides and aldehydes in biodiesel exhaust. The lower content of PAH is reflected by a weaker mutagenicity compared to DF exhaust. However, recent studies show a very low mutagenicity of DF exhaust as well, probably caused by elimination of sulfur in present DF qualities and the use of new technology diesel engines. Combustion of vegetable oil (VO) in common diesel engines causes a strongly enhanced mutagenicity of the exhaust despite nearly unchanged regulated emissions. The newly developed fuel "hydrotreated vegetable oil" (HVO) seems to be promising. HVO has physical and chemical advantages compared to FAME. Preliminary results show lower regulated and non-regulated emissions and a decreased mutagenicity.