Over the last 25 years, the effects of fatty acids on the immune system have been characterized usingin vitro, animal and human studies. Advances in fatty acid biochemistry and molecular techniques have recently suggested new mechanisms by which fatty acids could potentially modify immune responses, including modification of the organization of cellular lipids and interaction with nuclear receptors. Possibilities for the clinical applications ofn-3 PUFA are now developing. The present review focuses on the hypothesis that the anti-inflammatory properties ofn-3 PUFA in the arterial wall may contribute to the protective effects ofn-3 PUFA in CVD, as suggested by epidemiological and secondary prevention studies. Studies are just beginning to show that dietaryn-3 PUFA can be incorporated into plaque lipid in human subjects, where they may influence the morphology and stability of the atherosclerotic lesion.