The aim of the present paper is to briefly review the literature relating to clinical studies of the use of polyunsaturated long-chain fatty acids in the treatment of inflammatory bowel diseases (IBD) such as ulcerative colitis and Crohn's disease. The reasons for the discrepancies in the findings could be related to the different study designs, different treatments, overlapping of treatment effects, as well as the variety of treatment formulations and doses used, which have led to results that are, in certain instances, very difficult to explain. Emphasis on a treatment formulation which reduces the incidence of side effects, together with careful selection of patients and experimental design, seems to be associated with benefits, and these studies point to the therapeutic potential for these lipids in the therapy of IBD. It is possible that these fatty acids act by reducing low-grade active inflammation rather than by preventing reinitiation of the inflammatory process from a truly quiescent state. Whether this treatment is applicable to all IBD patients has not been fully elucidated. Nevertheless, taken together, all these studies suggest the effectiveness of these new therapeutic approaches, not only when conventional treatment fails or when it is not possible to treat chronically, but also, in some instances, as first choice.