A number of industries currently produce varying concentrations of heavy metal laden waste streams with significant consequences for any receiving environmental compartment. In recent years, increasing emphasis has been placed on environmental impact minimisation and resulting from this the range and capability of natural and prepared materials capable of heavy metal removal has seen steady development. In particular considerable work has been carried out on the use of both natural materials and their modifications. These natural materials, in many instances are relatively cheap, abundant in supply and have significant potential for modification and ultimately enhancement of their adsorption capabilities. This review paper reviews the current state of research on the use of the naturally occurring material cellulose, its modified forms and their efficacy as adsorbents for the removal of heavy metals from waste streams. Adsorbents based on direct modification of cellulose are evaluated initially and subsequently modifications resulting from the grafting of selected monomers to the cellulose backbone with subsequent functionalisation are assessed. The heavy metal adsorption capacities for these modified cellulose materials were found to be significant and levels of uptake were comparable, in many instances, to both other naturally occurring adsorbent materials and commercial ion exchange type resins. Many of the modified cellulose adsorbents proved regenerable and re-usable over a number of adsorption/desorption cycles allowing recovery of the adsorbed heavy metal in a more concentrated form.