Introduction: Selenium is a trace element whose importance for the functioning of the organism in health and disease is very intensively studied in modern research. This scientific evidence is constantly being supplemented, which requires monitoring and evaluation. Aim: The aim of this review paper is to systematize the results of relevant scientific research on the role of selenium in health preservation and promotion and the prevention of disease. Method: Available literature in English from the PubMed database was searched using the keywords "selenium"; "health"; "disease"; "toxicity"; "food"; "deficiency"; "cancer" and "diabetes mellitus". Results: Selenium is a microelement that manifests a powerful antioxidant effect within the enzyme phospholipid hydroperoxide glutathione peroxidase, while as a part of the enzyme deiodinase plays a role in the transformation of thyroxine into triiodothyronine. Brazilian nut is a food with an extremely high concentration of selenium, followed by tuna and oysters. Selenium deficiency in the body manifests as cardiomyopathy (Keshan disease) or osteoarthritis (Kashin-Beck's disease). Selenium poisoning is characterized by gastrointestinal and neurological symptoms, changes in the skin, on nails and garlic breath. Although a negative correlation has been observed between selenium concentration and the risk of carcinoma (breast, prostate, cervical, liver, gastric, thyroid, colorectal and bladder), studies have not shown so far a significant effect of selenium nutritional intake or supplementation in the prevention of cancer. Selenium concentrations are significantly lower in hepatitis, cirrhosis of the liver, obesity, autoimmune diseases (Hashimoto's disease, psoriasis, rheumatoid arthritis, ulcerous colitis, Crohn's disease), AIDS, and COVID-19, compared to healthy people. On the other hand, excessive selenium intake can increase the risk of diabetes mellitus type 2. Conclusion: Selenium has a significant physiological role in preserving health, primarily as an antioxidant and in the functioning of the thyroid gland, while selenium deficiency can be manifested by cardiomyopathy and osteoarthritis. Low concentrations of selenium in the body may increase the risk of several diseases: cancer, autoimmune diseases, AIDS and COVID-19. On the other hand, excessively high doses of selenium may increase the risk of diabetes mellitus or even poisoning - selenosis.