Octacosanol, a low–molecular-weight primary aliphatic alcohol, is the main component of a natural product wax extracted from plants. Most studies have used a wheat-germ oil extract, or policosanol, a natural mixture of primary alcohols isolated from sugar cane wax, of which octacosanol is the main component (approximately 67% of policosanol is octacosanol). It has a number of indications for its use, many of which are currently being researched. Moreover, a small controlled study showed that some patients with mild Parkinsonism claimed of benefit from octacosanol. Although some research has been conducted using policosanol, little research is currently available that focuses on octacosanol alone. Studies have also found that octacosanol may inhibit the production of cholesterol. In the early 1990s, researchers at Dalmer Laboratories in La Habana Cuba isolated and produced the first policosanol (PC) supplement. The original PC supplement has been approved as a cholesterol-lowering drug in over 25 countries throughout the Caribbean and South America. Cuban studies claim that 1 to 20 mg/day of the original PC supplement are effective at producing significant reductions in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). These studies also show that PC supplements are potent antioxidants, promote proper arterial endothelial cell function, inhibit platelet aggregation and thrombosis, and serve as effective treatments for intermittent claudication. However, for the most part, those studies reporting therapeutic efficacy of PC were carried out by one research group situated in Cuba. Conversely, research groups outside of Cuba have failed to validate the cholesterol-lowering and antioxidant efficacy of PC. Cuban researchers, however, continue to claim that the efficacy is attributed to the unique purity and composition of the original PC preparation, a mixture not found in PC products used by external research groups. The absence of independent and external studies confirming the therapeutic benefits of PC in disease prevention and treatment raises questions regarding their true efficacy. Octacosanol also may prevent from atherosclerosis through activation of the PI3K/Akt and MAPK/Erk1/2 signaling pathways.