NOD-like receptors (NLRs) are a family of 23 receptors known as pattern recognition receptors (PRRs), they are expressed in many cell types and play a key role in the innate immune response. The NLRs are activated by pathogen associated molecular patterns (PAMPs) which include structurally conserved molecules present on the surfaces of bacteria. The activation of these NLRs by pathogens results in the downstream activation of signalling kinases and transcription factors, culminating in the transcription of genes coding for pro-inflammatory factors. NLR expression is altered in many cellular, physiological and disease states. There is a lack of understanding of the mechanisms by which NLR expression is regulated, particularly in chronic inflammatory states. Genetic polymorphisms and protein interactions are included in such mechanisms. This review seeks to examine the current knowledge regarding the regulation of this family of receptors and their signalling pathways as well as how their expression changes in disease states with particular focus on NOD1 and NOD2 in inflammatory bowel diseases amongst others. This article is protected by copyright. All rights reserved.