Prostanoids are a group of potent bioactive lipids produced by oxygenation of arachidonate or one of several related polyunsaturated fatty acids. Cellular prostaglandin biosynthesis is tightly regulated, with a large part of the control exerted at the level of cyclooxygenase catalysis by prostaglandin H synthase (PGHS). The two known isoforms of PGHS have been assigned distinct pathophysiological functions, and their cyclooxygenase activities are subject to differential cellular control. This review considers the contributions to cellular catalytic control of the two PGHS isoforms by intracellular compartmentation, accessory proteins, arachidonate levels, and availability of hydroperoxide activator.