The dietary intake of sodium chloride has increased considerably over the last few decades due to changes in the human diet. This higher intake has been linked to a number of diseases including hypertension and other cardiovascular diseases. Numerous international health agencies, as well as the food industry, have now recommended a salt intake level of about 5-6 g daily, approximately half the average current daily intake level. Cereal products, and in particular bread, are a major source of salt in the diet. Therefore, any reduction in the level of salt in bread would have a major impact on global health. However, salt is a critical ingredient in bread production, and its reduction can have a deleterious effect on the production process. This includes an impact on dough handling, as well as final bread quality characteristics, including shelf-life, bread volume, and sensory characteristics, all deviating from the expectations of bakers and consumers. This review describes the effect of salt reduction during bread production and the resulting problems, both technological and qualitative, as well as evaluating some techniques commonly used to replace sodium chloride.