Consumption of table sugar has been increasing despite the warnings of public health officials as to the potential adverse consequences of sugar consumption. The World Health Organization recommends restricting consumption of sugars to no more than 10% of daily caloric intake, with a proposal to lower this level to 5% or less for optimal health. Unfortunately substituting sugar with the currently available artificial sweeteners does not appear to have favorable clinical effects. Given the health-related concerns with the currently available sweeteners such as increased risk of obesity and type 2 diabetes there is renewed interest in identifying a safe and palatable sweetener. The sweet extracts of natural plants such as stevia and monk fruit as well as naturally occurring rare sugars have become attractive alternatives. Although most of the sweeteners are sugars, there are some proteins such as braziien and miraculin that have intense sweetness and are being developed as sweeteners. Several companies are pursuing the development of "bitterness-blockers" to remove flavor defects. Other novel approaches include coating mineral carriers with sugar or hollowing out the sugar crystals. Naturally occurring rare sugars such as D-allulose (D-psicose), D-tagatose, D-sorbose and D-allose are attractive sweeteners. They do have the bulk and the mouth fill of table sugar with reduced caloric content (0.2 kcal/g for D-allulose). Additional randomized controlled trials are necessary to define the long term safety and efficacy of these sugars.