CYP2J2 is a cytochrome P450 monooxygenase that catalyzes epoxidation of polyunsaturated fatty acids (PUFA) in the cardiovascular system and other extrahepatic tissues. It converts arachidonic acid to epoxyeicosatrienoic acids (EETs), which serve as cardioprotective lipid mediators involved in vasodilation and angiogenesis. The enzyme also participates in eicosanoid metabolism through a hydroperoxide isomerase activity independent of NADPH and oxygen, generating vasodilatory metabolites. Additionally, CYP2J2 metabolizes xenobiotics including astemizole, terfenadine, amiodarone, and anthelmintics such as albendazole. CYP2J2 variants associate with ischemic stroke risk in Chinese populations; carriers of the GT genotype at the −50G/T position showed elevated stroke risk with an odds ratio of 2.32 1, and another study found CYP2J2 polymorphisms associated with hypertensive intracerebral hemorrhage risk 2. In colorectal cancer, Fusobacterium nucleatum infection upregulates CYP2J2 and its product 12,13-EpOME to promote epithelial-mesenchymal transition and metastasis; high CYP2J2 levels correlated with worse overall survival in stage III/IV patients 3. CYP2J2 represents a therapeutic target in cancer, where specific inhibitors such as C26 reduced tumor proliferation and promoted apoptosis 4. CYP2J2 inhibition may increase cardiotoxicity risk through reduced EET levels and QT prolongation 5, warranting careful consideration in drug development.