Glutathione (GSH) is an ubiquitous thiol-containing tripeptide that plays a key role in cell biology. It modulates cell response to redox changes associated with the reactive oxygen species, detoxifies the metabolites of drugs; regulates gene expression and apoptosis, and is involved in the transmembrane transport of organic solutes. Polymorphism has been observed in key enzymes of GSH metabolism and some alleles have been associated with an impaired redox buffer system downsteam diseases, and susceptibility to ischaemia. These varied activities make GSH an attractive target for a more reductionist approach to the prevention and management of many conditions of interest to surgeons.