The potential impact of macular pigment on the development of age-related macular degeneration (AMD) is currently a major research avenue. The role of oxidative damage in the pathogenesis of AMD has been recently confirmed by the results of a large randomized clinical trial, the AREDS (Age-Related Eye Disease Study). This study has established that high-dose supplementation with vitamins C and E, beta carotene, and zinc might prevent AMD progression and visual acuity loss in a large but determined subset of patients. Macular pigment components (mainly lutein and zeaxanthin) are highly resistant to free radicals. Moreover, extensive data from clinical, epidemiological and experimental studies suggest that lutein and zeaxanthin might protect against the development of AMD. Furthermore, an additional intake of lutein and/or zeaxanthin seems to induce an increase of the density of the macular pigment. However, a careful review of the available data suggest that only future randomized clinical trials will allow to determine the exact role of lutein and zeaxanthin in the prevention of AMD.