Abstract. We investigated the effect of highly purified eicosapentaenoic acid ethyl ester (EPA-E) on blood coagulation abnormalities and dysfunction of vascular endothelial cells in spontaneously diabetic Otsuka Long-Evans Tokushima Fatty rats. The animals were treated with either EPA-E or lard at a daily dose of 0.3 g/kg/day for 52 weeks by gavage, and their coagulation/fibrinolytic parameters, platelet aggregation, and functions of the vascular endothelial cells were examined. EPA-E significantly improved coagulation-related parameters including prothrombin time, activated partial thromboplastin time, fibrinogen level, and activities of factor II, V, VII, VIII, IX, X, XI, and XII, and antithrombin III, and fibrinolysis-related parameters including plasminogen, tissue-type plasminogen activator, a 2 -plasmin inhibitor, and plasminogen activator inhibitor. It also suppressed ADP-or collagen-induced platelet aggregation and the cholesterol/ phospholipid molar ratio in platelet membranes at a dose of 0.3 g/kg. In addition, it significantly increased the migration activity of vascular endothelial cells, and decreased the binding of vascular endothelial cells to vascular endothelial growth factor. In contrast, lard had no effect on hypercoagulation, hypofibrinolysis, and platelet hyperaggregation but significantly aggravated the dysfunction of vascular endothelial cells. These data demonstrate that EPA-E beneficially altered certain factors known to promote thrombosis and atherosclerosis in this animal model. WE reported previously that the long-term administration of highly purified eicosapentaenoic acid ethyl ester (EPA-E), an n-3 polyunsaturated fatty acid, which has an inhibitory effect on platelet aggregation and lipid-lowering effect, causes an improvement of insulin resistance in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model of spontaneous noninsulin-dependent diabetes mellitus with obesity [1] and that of high sucrose-induced insulin resistance in Dahl salt-sensitive (Dahl-S) rats [2]. It is well recognized that hyperglycemia enhances many risk factors for arteriosclerosis and works as a thrombus-forming factor via causing blood coagulation abnormalities and dysfunction of vascular endothelial cells and thrombocytes [3,4]. Thus, in the present study, we investigated the effect of EPA-E on blood coagulation abnormalities and