Omega-3 polyunsaturated fatty acids, such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are known by their anti-inflammatory effects through mechanisms such as formation of specialized pro-resolving mediators (SPM), and more recently a new mechanism dependent on the free fatty acid (FFA) receptors has been studied. DHA and EPA have shown an effect on the release of prostaglandins (PGs) E2 and F2α in endometrial cells, two PGs that have key function in fertility. In addition, other molecules such as cyclooxygenase-2, IL-1β, NF-κB, and intracellular signaling pathways are also affected by omega-3 fatty acids in endometrial cells. In this chapter, we will expose the following issues: eicosanoids in fertility and immune function in the uterus, effect of omega-3 fatty acids on endometrial function: in vivo and in vitro studies, mechanisms of action of omega-3 fatty acids in endometrial cells, and perspectives in health and diseases.