The present review provides a comprehensive discussion of the prebiotic, anti-diabetic, anti-colorectal cancer, and anti-cardiovascular disease effects of unripe banana flour resistant starch (BFRS). Unripe banana flour is considered a useful ingredient in the food industry because it has high levels of resistant starch (up to 68% w/w). The beneficial effects of BFRS against diabetes, obesity, cardiovascular disease, and colorectal cancer emanate from its resistance to hydrolysis and propensity to escape digestion in the upper-gastrointestinal tract, which delays glucose absorption and increases the concentration of colonic short-chain fatty acids (acetate, propionate, and butyrate). Therefore, BFRS can be recommended as an alternative functional ingredient in food products. However, more in vivo studies with BFRS should be conducted to ascertain the mechanisms that underly its beneficial effects and associated changes in the gut microbiome. The influence of other food product ingredients and food processing on BFRS efficacy and targeted production of specific short-chain fatty acids in the colon, needs to be investigated to optimize its application.