Colorectal cancer (CRC) is the second most common cancer in Japan. Primary cancer prevention is especially desired for hereditary CRC patients, owing to the high incidence of cancer in these patients. Prophylactic total proctocolectomy is generally accepted for young FAP patients; however, this procedure may reduce their QOL. If we could obtain effective chemopreventive drugs for FAP patients, prophylactic surgery could be postponed until the patients are older, or be avoided altogether. Thus, such drugs would bring large benefits to FAP patients. In this review, the history of chemopreventive drug development for FAP and the future prospects of chemopreventive drugs are described.