Echinacea may improve the blood’s oxygen carrying capacity by increasing production of erythropoietin (EPO), which regulates red blood cell formation (1). In this review, the authors discuss the physiological variables associated with distance running performance and how these variables are influenced by Echinacea. The results showed that , the majority of the published literature does not support the claim that Echinacea is a beneficial ergogenic aid. With the exception of one study, several independent groups have reported Echinacea supplementation does not increase EPO production, blood markers of oxygen transport, VO2max or RE in healthy untrained or trained subjects. The authors conclude that the published literature does not support the use of Echinacea as an ergogenic aid to improve aerobic fitness in healthy untrained or trained subjects.