Eicosanoids are oxidized arachidonate-derived lipids products generated by lipoxygenase, cyclo-oxygenase and cytochrome P450. Their bioactivity is mediated via receptor-dependent mechanisms and they are involved in a diverse array of processes in both health and disease. For many years, GC-MS was the method of choice for eicosanoid analysis, but, more recently, the availability of high-sensitivity electrospray LC (liquid chromatography)-MS/MS (tandem MS) has provided a new approach for quantification, while minimizing sample preparation. The present review summarizes the various methods available for routine quantification of eicosanoids, focusing ultimately on their analysis using a hybrid Q-Trap mass spectrometer.