Alzheimer's disease (AD) is characterized by a microglial-mediated inflammatory response elicited by extensive amyloid deposition in the brain. Nonsteroidal anti-inflammatory drug (NSAID) treatment reduces AD risk, slows disease progression, and reduces microglial activation; however, the basis of these effects is unknown. We report that treatment of 11-month-old Tg2576 mice overexpressing human amyloid precursor protein (APP) with the NSAID ibuprofen for 16 weeks resulted in the dramatic and selective reduction of SDS-soluble -amyloid (A) 42 , whereas it had smaller effects on SDS-soluble A 40 levels. Ibuprofen treatment resulted in 60% reduction of amyloid plaque load in the cortex of these animals. In vitro studies using APP-expressing 293 cells showed that ibuprofen directly affected APP processing, specifically reducing the production of A 42 . Ibuprofen treatment resulted in a significant reduction in microglial activation in the Tg2576 mice, as measured by CD45 and CD11b expression. NSAIDs activate the nuclear hormone receptor peroxisome proliferatoractivated receptor ␥ (PPAR␥); however, a potent agonist of this receptor, pioglitazone, only modestly reduced SDS-soluble A levels and did not affect amyloid plaque burden or microglia activation, indicating that PPAR␥ activation is not involved in the A lowering effect of NSAIDs. These data show that chronic NSAID treatment can reduce brain A levels, amyloid plaque burden, and microglial activation in an animal model of Alzheimer's disease.