To discuss the benefits of fish oil in heart disease prevention and provide current recommendations for clinical use. Methods: Review of the literature. Results: Marine omega-3 fatty acids have an important role in reducing coronary artery disease (CAD) risk. This has been established by both epidemiologic and randomized intervention trials. While 4 g of omega-3 fatty acids per day are recommended to treat hypertriglyceridemia, the CAD-reducing effects occur with lower quantities and appear to be related to reducing the risk for sudden cardiac death. The American Heart Association currently recommends 1 g/day of omega-3 fatty acids for patients with CAD and for those without CAD the consumption of a variety of fish (preferably fatty fish) at least twice a week. Conclusion: Ongoing studies will continue to increase our understanding of the use of omega-3 fatty acids for reducing CAD risk