Antioxidant functional lipid supplements have been proven to be effective in reducing cardiovascular risks. However, the efficacy of functional lipids with antioxidant properties in reducing cardiovascular risk has not been consistent. To reconcile the inconsistencies in the literature regarding the role of antioxidant functional lipid supplementation in the development of health outcomes, we conducted a systematic review and meta-analysis of all available RCTs to investigate the effect of interventions with functional lipids with antioxidant properties on CVD risk factors. Randomized controlled trials (RCTs) reporting estimates for the effects of antioxidant functional lipid supplementation on cardiometabolic risk factors published up to May 1st, 2024, were searched. Overall, antioxidant functional lipid supplementation, compared with placebo, had favorable effects on systolic blood pressure (lycopene: -1.95[-3.54, -0.36]mmHg), low-density lipoprotein cholesterol (n6 fatty acid: -0.39[-0.71,-0.06]mmol/L; astaxanthin: -0.11[-0.21, -0.01]mmol/L), high-density lipoprotein cholesterol (n3 fatty acid: 0.20[0.13, 0.27]mmol/L; n6 fatty acid: 0.08[0.01, 0.14]mmol/L; astaxanthin: 0.13[0.05, 0.21]mmol/L), total cholesterol (n6 fatty acid: -0.24[-0.37, -0.11]mmol/L; astaxanthin: -0.22[-0.32, -0.12]mmol/L; beta-carotene: -0.13[-0.23, -0.04]mmol/L), triglyceride (n3 fatty acid: -0.37[-0.47,-0.28]mmol/L; astaxanthin: -0.46[-0.83, -0.10]mmol/L) and fasting blood insulin (astaxanthin: -2.66[-3.98, -1.34]pmol/L). The benefits of antioxidant functional lipid supplementation appeared to be most evidenced in blood pressure and blood lipids in participants with different cardiometabolic health statuses. Notably, n9 fatty acid increased triglyceride and hemoglobin A1C, which increase CVD risk, in the total population. These data suggest that antioxidant functional lipid supplementation ameliorates cardiometabolic risk factors, while its effect may depend on the type and cardiometabolic health status. Long-term RCTs are needed in the future to corroborate risk-to-benefit ratios across different antioxidant functional lipid supplementation settings.