Animal, tissue culture, and human studies have evaluated the effects of fish oil supplementation in patients with rheumatoid arthritis (RA) over the last two decades. These studies have clearly shown potentially beneficial changes in cytokine and eicosanoid metabolism. The overall clinical improvement, however, has been only moderate. European clinical trials have shown significant pain reduction in patients with RA treated with vitamin E. A recent animal study in RA-prone mice evaluated the effects of vitamin E in addition to omega-3 and omega-6 fatty acids on cytokine and eicosanoid production. The authors suggest that vitamin E might have an additional positive effect on autoimmune disease by decreasing proinflammatory cytokines and lipid mediators. Is this information ultimately important in terms of dietary advice for patients with RA? Are further clinical trials indicated? The following article will present a brief critical review.