Cancer chemoprevention is employed to block or reverse the progressionof malignancies. To date, several thousand agents have been found to possesschemopreventive activity. One such compound is capsaicin, a component of chilipeppers that exhibits anti-growth activity against various cancer cell lines. Capsaicinexerts its cytotoxic action by activating an array of signaling mechanisms, includinggeneration of reactive oxygen species (ROS) as messengers to initiate apoptosis, atype I programmed cell death. However, numerous in vitro and in vivo studies havesuggested that capsaicin also possesses tumor-promoting activity; possibly in part,refl ecting activation of autophagy, an alternative (type II) programmed deathprocess. This article reviews the recent literature on the paradoxical effects ofcapsaicin on cancer growth and the diverse capsaicin-induced signaling pathwaysthat lead to cell death or tumorigenesis . Some of the most common cellular targetsof capsaicin are also discussed