Purpose: To invesigate the association between omega fatty acids and age-related macular degeneration (AMD) Methods:<We conducted a nested case-control study in the 7 country population-based EUREYE study. Of 158 cases with AMD, 149 (46 geographic atrophy, 103 neovascular) had stored blood samples. Cases were matched by country, sex and age (frequency matched within 1 year)with controls who had no signs of early ARM or AMD. Bloods were analysed by capillary gas-liquid chromatography for omega fatty acids: linoleic (LA), alpha linolenic (ALA), eicosapentaenoic (EPA), docosahexanoic(DHA). Statistical analysis was by logistic regression adjusted for potential counfounders (smoking, myocardial infarction, diabetes, serum antioxidants). Results: ALA was signficantly associated with AMD in both univariate and adjusted analyses with OR for the highest versus lowest tertile of 0.25 (0.11, 0.52), p = 0.0001. Increasing quartiles of LA were associated with decreasing odds of AMD, eg. OR for highest versus lowest quartile of 0.45 (0.23, 0.89) p = 0.02. DHA showed a reduced association for highest versus lowest quartile but was not signfiicant, OR 0.55 (0.27, 1.09) p = 0.09. EPA was not associated with AMD. Conclusions: In contrast to studies based only on dietary analyses, our results based on blood analysis showed strong inverse associations with higher blood levels of LA and ALA.