Milk presents a unique lipid variety, including several hundreds of different fatty acid species with various bioactivities. However, bovine milk fat still suffers from a bad image in the lay public because it is rich in saturated fatty acids, which are perceived as associated with deleterious health effects only. In contrast, recent meta-analyses report lack of correlation between milk fat consumption and cardiovascular diseases, and some analyses even report protective effects. This chapter will first focus on the major recent scientific advances on the impact of specific molecular fatty acid species (among which specific odd and trans species, including trans-palmitoleic acid) and supramolecular structures of milk fat (the milk fat globule and its membrane, rich in polar lipids) on several aspects of lipid metabolism and metabolic disease risk. We will highlight possible mechanisms, such as those related to the impact of milk lipids in the gut. This includes residues of sphingolipids, which can reach the colon and exert effects of physiological interest. Secondly, we present the recent advances in infant nutrition science related to knowledge gained on the importance of milk fat globule structure, breastmilk vs infant formula, on metabolic programming and the recent advances in this field.