The omega class of glutathione transferases (GSTs) is a relatively ancient member of the cytosolic GST superfamily, and the omega-class GSTs are found in plants, animals, and some microbial species. The omega-class GSTs exhibit the canonical GST fold, but, unlike other GSTs, the omega-class GSTs have a cysteine residue in their active site. Consequently, the omega-class GSTs catalyze a range of thiol transferase and reduction reactions that are not catalyzed by members of the other classes. Human GSTO1-1 can catalyze the reduction of monomethylarsonic acid (V), but this does not appear to be physiologically important in cases of high environmental arsenic exposure. GSTO1-1 also plays an important role in the biotransformation of reactive α-haloketones to nontoxic acetophenones. Genetic variation is common in the omega-class GST genes, and variants that result in deficiency of GSTO1-1 have been characterized. Genetic linkage studies have discovered associations between GSTO genes and the age at onset of Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. The mechanism underlying this association with neurological disease may derive from the capacity of omega-class GSTs to mitigate oxidative stress or their role in activating the proinflammatory cytokine, interleukin-1β.