Long-chain polyunsaturated fatty acids (LCPUFAs) such as docosahexanoic acid (DHA) have been the center of attention for the past 30 years. What is our stance today regarding the role of DHA as a conditionally essential nutrient? Professor Susan Carlson reviews the large body of conflicting evidence for and against LCPUFA use. Today’s randomized controlled trials do not show any conclusive benefits for pre- or post-natal DHA supplementation. Carlson, however, suggests that there is missing information buried within the bulk of data obtained from these studies. A major problem with many studies is the early cut-off dates for assessment of clinical outcomes. Indeed, the effects of prenatal DHA supplementation may only be evident in later childhood. Carlson cites long-term follow-up data on 4-6 year-old children that reveal startling effects of maternal DHA supplementation on cognitive measures, including school-age IQ scores. Carlson ends by showing exciting preliminary findings from her KUDOS study, supporting the benefits of LCPUFA on preventing early pre-term birth and the incidence of very low birth weight infants. Additional follow up of the KUDOS results will shed light on the long-term cognitive outcomes.