Numerous studies have reported the protective properties of carotenoid supplementation against skin and eye associated diseases. However, conflicting data concerning the efficacy of beta-carotene in the pathogenesis of cancers and cardiovascular disease exist. It has been shown that beta-carotene is an effective antioxidant on its own or in combination with other antioxidants. Red palm oil (RPO) is a potent anti-oxidant rich oil which consists of carotenoids, tocopherols, tocotrienols and lycopenes as well as lipid fractions such as squalene, saturated and unsaturated fatty acids (which maximize absorption of these anti-oxidants) and Co-enzyme Q10. alpha and beta-carotene account for more than 90% of the total carotene in RPO. It is known that ischaemia/reperfusion-induced injury causes an imbalance in oxygen supply which can lead to oxidative stress in the heart. It has been shown that the mitogen-activated protein kinases (MAPKs), PKB/Akt and the NO-cGMP all play vital roles in ischaemia/reperfusion injury in the heart. Therefore, our review mainly focuses on the signaling pathways involved in functional recovery induced by a natural carotenoid oil after ischaemia/reperfusion injury.