Leukotriene A4 hydrolase catalyzes the final and committed step in the biosynthesis of leukotriene B4, a potent chemotactic agent for neutrophils, eosinophils, monocytes, and T-cells that play key roles in the innate immune response. Recent data strongly implicates leukotriene B4 in the pathogenesis of cardiovascular diseases, in particular arteriosclerosis, myocardial infarction and stroke. Here, we highlight the most salient features of leukotriene A4 hydrolase with emphasis on its biochemistry and structure biology.