Recent
decades have revealed increasing evidence for epigenetic inheritance
through paternal environmental exposures and experiences, affecting
offspring health outcomes across diverse species. Key epigenetic
mediators in sperm may include DNA methylation, chromatin modifications,
as well as small and long non-coding (nc)RNAs. Identified environmental
influences extend beyond lifestyle factors (e.g., exercise, diet,
alcohol, and nicotine use) to include stress, infections, pollutants,
and other toxins. Evidence from humans, rodents, and other species
suggests that various paternal exposures before conception substantially
shape the phenotypes in offspring, via developmental modulation,
including changes to brain and behavior, metabolism, endocrinology, and
physiology. These findings raise concerns regarding human epigenetic
inheritance, because the relevant environmental exposures have changed
significantly in recent decades, potentially increasing the risk of
future generations for various disorders (‘transgenerational
epigenopathy’). Here, we integrate evidence for paternal environmental
exposures affecting offspring phenotypes, and associated epigenetic
mechanisms, critically discussing potential implications for medicine
and other scientific fields.