With heart disease being the leading cause of death in the US and an important cause of mortality worldwide, there has been increasing interest in dietary supplements that may provide adjunctive therapy to standard medications. Fiber products, traditionally used for alleviating gastrointestinal states such as constipation, have also been investigated for their potential beneficial cardiovascular effects. Psyllium is a soluble dietary fiber derived from the plant Genus Plantago. The FDA has recently approved the use of daily intake of 3g to 12g of psyllium seed husks to reduce the risk of heart disease, when taken as part of a low fat, low cholesterol diet. This paper reviews recent clinical studies investigating the effects of psyllium on cardiovascular risk factors, focusing specifically on total and LDL cholesterol. The majority of studies show that psyllium modestly lowers total and LDL cholesterol levels in mild to moderate hypercholesterolemic people. The effects of psyllium depend on a wide range of variables including dosage and baseline lipid levels. The mechanism for cholesterol reduction likely involves increasing bile acid excretion and synthesis, and by affecting the levels of hepatic enzymes involved in lipid metabolism. Further studies will need to be conducted to identify the efficacy of psyllium use as adjunctive therapy with standard medications such as statins, its effects on normocholesterolemic people, and its long term safety profile.