Coeliac disease (CD) is a long-life intolerance to gluten proteins, with prevalence of 1–2% worldwide and health consequences if not treated. Currently, the treatment is the dietary gluten withdrawal, but commercial gluten-free foodstuffs present undesirable properties. Therefore, attempts are being made to modify the immunogenic sequences of gluten to avoid recognition by the immune system and to prepare safe and acceptable foods. These include long-time fermentation by sourdough and enzymic modification. The present article reviews our current knowledge of the pathogenesis of CD and the advantages and limitations of the current approaches to gluten modification and to develop safer foods for CD patients.