A brief overview is given in this article on the main design philosophies and the resulting description concepts used for components which undergo monotonic and cyclic loading. Emphasis is put on a mechanistic approach avoiding a plain reproduction of empirical laws. After a short consideration of fracture as a result of monotonic loading using fracture mechanics basics, the phenomena taking place as a consequence of cyclic plasticity are introduced. The development of fatigue damage is treated by introducing the physical processes which (i) are responsible for microstructural changes, (ii) lead to crack initiation and (iii) determine crack propagation. From the current research topics within the area of metal fatigue, two aspects are dealt with in more detail because of their relevance to biomechanics. The first one is the growth behaviour of microstructural short cracks, which controls cyclic life of smooth parts at low stress amplitudes. The second issue addresses the question of the existence of a true fatigue limit and is of particular interest for components which must sustain a very high number of loading cycles (very high cycle fatigue).