Aluminium toxicity may act in two distinct ways, depending on the level of contamination. Relatively low aluminium levels from environmental origin (mainly from drinking water poor in silica) have been shown to be statistically associated with senile dementias of Alzheimer type (chronic intoxication). In addition, high aluminium therapeutic levels (from phosphate binders, antacids, …) can induce different, more rapid, symptoms (acute intoxication). In all cases, aluminium toxicity is largely conditioned by aluminium bioavailability, which in turn hinges upon aluminium coordination chemistry in vivo. The highly polarising power of the Al 3+ ion dictates its particular affinity for oxygen donors that abound in essential biomolecules and dietary substances. The influence of these substances on aluminium bioavailability, metabolism and toxicity can be assessed through animal models. However, understanding the mechanisms through which aluminium–ligand interactions may influence physiological processes on the molecular level requires a knowledge of the speciation of the metal in the main biofluids. Access to this critical information can a priori be gained through direct experimental analysis of relevant biological samples. It is in this way that aluminium protein-bound fractions, involving essentially transferrin, have been identified, but using such a direct approach to analyse the ultrafiltrable pool of the metal is a virtually insurmountable task, hence the necessity to have recourse to computer-aided speciation techniques based on simulation models. Following a previous review published in this journal on nearly the same topic Coord. Chem. Rev. 149 (1996) 241, this article updates the knowledge available on both biological and chemical fronts. After a review of experimental investigations led on the roles of aluminium–ligand interactions in aluminium bioavailability, metabolism and toxicity, contributions of experimental and computer-aided speciation to the understanding of the relevant processes are then analysed. Significant progress has been made in the diverse aspects of the biological field, in particular, in relation to the role of dietary ligands on aluminium gastrointestinal absorption, excretion and tissue distribution. Also, very intensive research has been pursued on the design of new aluminium sequestering agents to treat acute intoxications. Some progress has also been made on the chemical side relative to computer-aided speciation applications to gastrointestinal and blood plasma conditions. However, the gap is increasing between the large body of observations made by physiologists and toxicologists and the few data painfully obtained by coordination chemists to interpret the relevant phenomena.