Iron is a double edged sword for living systems, as it is essential for a wide range of metabolic processes while it also has potential deletereous effects. Oxidative metabolism during ischaemic stroke together with high iron content in the brain synergise to increase the oxidative damage. High plasma ferritin, as a measurement of iron stores, and high cerebrospinal fluid ferritin have been related to poor outcome in stroke patients. Iron has been found in pooled gruels of atheromatous lesions and has been related to other diseases. Further epidemiological studies are required to determine the effect of iron on the development of cardiovascular diseases. Until the precise effect of iron overloading is established it is recommended that iron supplements should only be prescribed when there is a clear deficiency.