In the United States, cardiovascular disease (CVD) is the most common cause of death in older people. The use of omega-3 fatty acid supplements (nonprescription) is common in older people, despite the conflicting evidence regarding the benefits of supplements in CVD. The 2017 American Heart Association science advisory on omega-3 fatty acid supplements suggested that it is reasonable to use omega-3 fatty acids for secondary prevention in people with coronary heart disease and heart failure. This article reviewed large meta-analyses and clinical trials published since the science advisory. Two metaanalyses concluded that these supplements were not effective for secondary or primary prevention of CVD. Two large randomized, placebo-controlled clinical trials, one in people with diabetes mellitus, evaluated omega-3 fatty acid supplements for primary prevention and reported no benefit. Taken together, these findings do not support the routine dietary supplementation with omega-3 fatty acids to prevent cardiovascular events.