This review discusses the role of omega-3 fatty acids, particularly icosapent ethyl, in reducing cardiovascular (CV) events, focusing on their mechanisms of action and clinical implementation. Despite effective LDL-C lowering, high-risk patients still harbor residual CV risk. Omega-3 fatty acids, especially icosapent ethyl, have shown promise in lowering this residual risk, particularly in patients with hypertriglyceridaemia treated with statins. The mechanisms of action include lowering triglyceride (TG) levels, reducing VLDL production, and stimulating lipoprotein lipase. Beyond TG lowering, omega-3 fatty acids have pleiotropic effects, including anti-inflammatory and antithrombotic properties, which may contribute to atherosclerosis reduction. Randomized trials such as REDUCE-IT have demonstrated significant reductions in CV events with icosapent ethyl, supporting its use in clinical practice. Guidelines now recommend icosapent ethyl as an adjunct to statin therapy in patients with hypertriglyceridaemia and established CVD or diabetes. However, considerations such as the risk of atrial fibrillation and the need for dietary sources of omega-3 fatty acids are also discussed. The future of omega-3 fatty acids in CV event reduction lies in further research and real-world implementation.This review discusses the role of omega-3 fatty acids, particularly icosapent ethyl, in reducing cardiovascular (CV) events, focusing on their mechanisms of action and clinical implementation. Despite effective LDL-C lowering, high-risk patients still harbor residual CV risk. Omega-3 fatty acids, especially icosapent ethyl, have shown promise in lowering this residual risk, particularly in patients with hypertriglyceridaemia treated with statins. The mechanisms of action include lowering triglyceride (TG) levels, reducing VLDL production, and stimulating lipoprotein lipase. Beyond TG lowering, omega-3 fatty acids have pleiotropic effects, including anti-inflammatory and antithrombotic properties, which may contribute to atherosclerosis reduction. Randomized trials such as REDUCE-IT have demonstrated significant reductions in CV events with icosapent ethyl, supporting its use in clinical practice. Guidelines now recommend icosapent ethyl as an adjunct to statin therapy in patients with hypertriglyceridaemia and established CVD or diabetes. However, considerations such as the risk of atrial fibrillation and the need for dietary sources of omega-3 fatty acids are also discussed. The future of omega-3 fatty acids in CV event reduction lies in further research and real-world implementation.