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Introduction: Colon cancer is one of the major human malignancies worldwide, and much effort has been applied to understand the process of colon carcinogenesis, as well as the role of potential treatments and co-therapeutical agents against it. A growing body of evidence suggests that the use of fluoxetine (FLX), an antidepressant belonging to the selective serotonin reuptake inhibitors (SSRIs), may be associated with a reduced colon cancer risk. However, controversial opinions have been published and an identification of the mechanisms of the activity of FLX on colon cells would help in the clarification of this controversy. Objectives: Using several in vitro and in vivo-based methods and analyses, we aimed to verify whether FLX has antioxidant, pro-oxidant or DNA-damaging potential in standard toxicological assays; to check whether and how FLX could prevent and reduce colon preneoplastic lesions; to ascertain whether FLX has any oncostatic potential against colon tumors; and, to investigate whether FLX activity could be comparable with a known and current applied chemotherapeutic agent against colon cancer. Results: FLX did not have any antioxidant potential in our experiments. Although it did not induce reactive oxygen species (ROS) generation or DNA-damage in fibroblast and colon tumor cell lines, FLX reduced dysplasia and proliferation in two different carcinogen models. Further, a significant decrease in colon stromal reactivity and angiogenesis was found in both carcinogen-induced preneoplasia models. In a xenograft model of colon cancer, FLX shrank tumors, reduced tumor proliferation, arrested cancer cells at the G0/G1 cell-cycle phase, and took ROS generation under control. Such effects were detected together with an intracellular acidification and loss of mitochondrial membrane potential in FLX-treated cells. Modulating mitochondrial respiratory chain, HIF-1 expression and Akt/mTOR signaling pathway, FLX was found to reduce colon tumors similar to the widely used chemotherapeutic agent 5-Fluoracil activity. Conclusion: Our collective data suggest that FLX is a remarkable chemopreventive and oncostatic agent against colon preneoplastic lesions and tumors, acting without DNA-damage or ROS generation.