This review aims to summarise recent findings on the effects of omega-3 fatty acids (FAs) on skeletal muscle vascular and metabolic health. We particularly focus on macrovascular (large blood vessel) outcomes, skeletal muscle microvascular (capillary) blood flow and skeletal muscle health and metabolism. Recent meta-analysis and intervention studies suggest that omega-3 FAs improve macrovascular health outcomes in humans by enhancing endothelial function, reducing arterial stiffness and by increasing nitric oxide bioavailability. However, the benefits on macrovascular outcomes are more evident in clinical populations than in healthy individuals. In terms of dose, more than 1 g/day of omega-3 FA appear to be more beneficial than less than 1 g/day. In contrast to macrovascular outcomes, the effect of omega-3 FAs on skeletal muscle microvascular outcomes remains undetermined, demonstrating a significant gap in the field. In terms of skeletal muscle health and metabolism, omega-3 FAs improve muscle strength and ameliorate postprandial blood glucose levels in healthy individuals. The anti-inflammatory effects of omega-3 FAs also appear to benefit muscle health and metabolism. Omega-3 FAs have a positive effect on macrovascular outcomes, muscle metabolism and health, specifically in clinical populations. The direct effects of omega-3 FAs on muscle microvascular outcomes in both healthy and clinical populations need to be determined.