The main objective of this review was to address the possible mechanisms of action ofrnmoderate consumption of ethanol in the role of cardiovascular disease protection. The reviewrntried to compare the effect of heavy alcohol consumption and the cardiovascular disease riskrnwith moderate alcohol consumption.rnEpidemiological and clinical evidences indicate that there is a strong relationshiprnbetween heavy alcohol consumption and the risk of cardiovascular disease, notably, coronaryrnheart disease, atherosclerosis, peripheral arterial disease, hypertension and stroke,rncardiomyopathy and arrhythmias. However, light-moderate alcohol consumption is proved tornhave a protective role of these cardiovascular disease incidents.rnWhile the prevailing findings supported by a number of clinical and epidemiologic datarnindicates the ability of ethanol to elevate high density lipoprotein cholesterol is an importantrnmechanism in ameliorating cardiovascular diseases, other mechanisms where by moderaternethanol consumption could exert its beneficial effect have been proposed. That is, its ability tornaffect platelet function, preventing platelet aggregability and enhancing fibrinolysis activity,rnaffecting endothelial and vascular smooth muscle cell function, preventing smooth muscle cellrnproliferation and migration, reducing the oxidation of low density lipoproteins, reduction inrnapolipoprotiens(a) level in the blood, enhancing the synthesis and release of nitric oxide andrnprostacyclin, induction of cardioprotective proteins, increase insulin sensitivity and reducingrninsulin resistance, reducing blood pressure and possibly by reducing mental and psychosocialrnstress.