Nitrones have been extensively used for the detection of transient free radicals using electron paramagnetic resonance. Since the mid-80's, nitrones have also been widely used as protective agents against oxidative stress in several biological models. Due to the high potency of nitrones, there has been extensive research on the development of derivatives with improved biological and spin trapping properties as well as enhanced intra-cellular compartmentalization. The chemical and pharmacological properties of nitrones depend mainly on the connectivity as well as on the nature and the position of the substituents on the nitrone group. Therefore, novel bioactive molecules have been designed and the development of specific nitrone derivatives is aimed at providing new therapeutic approaches and perspectives in prevention, treatment and rehabilitation. This review focuses on the effects that are exerted by the most promising nitrone antioxidants that are available. A comprehensive description of the unique molecular mechanism and mediators that are targeted by these compounds is given to guide and enable novel and successful approaches to the treatment of a broad spectrum of diseases associated with stress and aging. New promising nitrone compounds are now available for further development by translational medicine that exert superior bioactivity and efficacy.