Naturally occurring antibodies (NAbs) have specificity for both microbial and self antigens, which allows them to act in the first line defense against invading pathogens, as well as in tissue homeostasis by mediating the clearance of cellular debris. This latter recognition of self by NAbs was often thought to reflect the polyreactivity of low affinity antibodies. The finding that oxidation-specific epitopes are dominant targets of naturally occurring IgM antibodies shed light on this and provided novel insights into the understanding of the house keeping functions of NAbs. Oxidation-specific epitopes represent stress-induced or altered self structures that are generated as a consequence of lipidperoxidation during many physiological and pathological situations. Importantly, the same structures have been found in the membranes of dying cells. Only oxidized lipids and dying cells-but not native membrane lipids or viable cells-are recognized by this set of NAbs. Thus, oxidation-specific epitopes represent ideal marks that identify biological waste for its clearance and the neutralization of its pro-inflammatory properties. Furthermore, this binding property of NAbs has also important implications for various chronic inflammatory diseases, including atherosclerosis.