With the development of techniques in genetic engineering, protein and peptide drugs have gained increased popularity. However, their clinical application is limited by several shrotcomings such as short half-time and high immunogenicity, which leads to the recent efforts made by many researchers in various chemical modifications of protein and peptide drugs. Compared with PEG modification, glycosylation and site-directed mutagenesis, modification with fatty acids results in good biological activity, improved stability and reduced immunogenicity of protein and peptide drugs. What's more, as important components of body fat, lipids and cell membrane phospholipids, fatty acids can increase drug lipophilicity and permeability through intestinal mucosa, and promote the association of drugs with their receptors. In this article, current advances in research on the modification of protein and peptide drugs with fatty acids were reviewed.