Selenium is an important micronutrient that is essential for the functioning of the human body. Being a component of the active center of several antioxidant enzymes selenium prevents cell injury by free radicals. Decline in selenium-containing enzymes results in progression of oxidative stress and chronic inflammation, which are considered as possible causes for the development of many cardiovascular diseases. This review focuses on mechanisms for prevention of myocardial and vascular injury through the adequate selenium supply to the body. The importance of monitoring and correction of the selenium status in appropriate patients is underlined.