In recent years, the association between dietary patterns and health has emerged as an important central concept in developing dietary recommendations, including the development of the US Dietary Guidelines. The Western dietary pattern is most commonly defined as a diet characterized by high intakes of refined grains, sugar, red meat and other animal products, and fat and has frequently been associated with negative health outcomes such as an increased risk of colon cancer, heart attack, and diabetes. Because a Western dietary pattern has been associated with adverse health outcomes in some studies, it is assumed that all dietary components are equally culpable, but this may not necessarily be the case. Disentangling the independent effects of individual foods, such as red meat (including lean beef), on health outcomes is a substantial challenge. This article reviews the myths and realities regarding the role of lean beef in various healthful dietary patterns.