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Introduction: This study investigated the effects of a marine oil extract (PCSO-524 ®) on inattention, hyperactivity, mood and cognition in children and adolescents. PCSO-524 ® is a standardised lipid extract of the New Zealand green-lipped mussel and is an inflammatory modulator that inhibits the 5′-lipoxygenase and cyclooxygenase pathways and decreases concentrations of the pro-inflammatory arachidonic acid (AA). Methods: PCSO-524 ® or a matched placebo was administered for 14 weeks to 144 participants (123 males/21 females; mean age 8.7 years) with high hyperactivity and inattention in a randomised, double-blind, placebo-controlled study. The primary outcome was the Conners Parent Rating Scale assessing parental reports of behavioural problems. Secondary outcomes assessed changes in cognition and mood. Results: The results of the present study did not support the hypothesis that PCSO-524® improves parental reports of hyperactivity, inattention and impulsivity in children ages 6 to 14 years over placebo. Repeated measures ANOVA on post hoc subsample analysis indicated significant improvements in hyperactivity ( p = 0.04), attention ( p = 0.02), learning ( p = 0.05) and probability of ADHD ( p = 0.04) with a medium to large average effect size ( d = 0.65) in those children who did not meet criteria for combined hyperactivity and inattention. Furthermore, significant improvements in the PCSO-524® group were indicated in a whole sample repeated measures ANCOVA on recognition memory between baseline and week 8 over placebo ( p = 0.02, d = 0.56); this difference was not sustained at week 14. Conclusions: The results presented indicate that PCSO-524 ® may be beneficial in reducing levels of hyperactivity and inattention in a population of children with clinical and subclinical symptoms of ADHD. [ABSTRACT FROM AUTHOR]