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Numerous preclinical and clinical studies have shown a correlation between the consumption of moderate amounts of red wine and a reduced risk of cardiovascular complications asso­ciated with atherosclerosis. Both polyphenolic components and ethanol are responsible for the apparent protective effects of red wine, as they influence different biochemical and cellu­lar processes and thus affect the development and progression of atherosclerosis. The polyphenolic compounds of red wine reduce the endothelial dysfunction and thus improve the endothelial function, prevent the oxidation of low-density lipoproteins (LDL), attenuate pro­liferation and migration of smooth muscle cells, inhibit platelet aggregation and adhesion and also reduce the serum concentration of inflammatory mediators. Ethanol, similarly to polyphenolic compounds of red wine, inhibits platelet aggregation and adhesion, but also increases the levels of high-density lipoproteins (HDL). The present paper describes the main pharmacologically active compounds of red wine and their impact on various processes in the progression and development of atherosclerosis