Cells bearing a smooth muscle cell marker--alpha-actin and a macrophage marker--CD68 antigen were immunocytochemically identified on 'en face' preparations of human aortic intima. Cells, expressing smooth muscle alpha-actin, macrophage CD68 antigen and both markers, i.e. smooth muscle cells possessing the macrophage antigen, were identified both in grossly normal aortic areas and in atherosclerotic lesions (fatty streaks and atherosclerotic plaques). CD68-positive smooth muscle cells were most common in the lipid-rich areas: fatty streaks and atherosclerotic plaque shoulders. Cells expressing smooth muscle alpha-actin and CD68 were also revealed in primary cultures prepared from grossly normal and atherosclerotic intima. Cells expressing both antigens were found in all examined cultures. The proportion of these cells in cultures from grossly normal areas and atherosclerotic plaques was similar: 14.5 +/- 4.1 and 14.6 +/- 4.8%, respectively. Cultures from fatty streaks had a higher content of cells expressing both antigens: 25.1 +/- 7.0%. Modified low density lipoprotein-induced intracellular lipid accumulation in cells cultured from grossly normal intima led to a three-fold increase in the number of cells sharing alpha-actin and CD68 antigen. Accumulation of latex beads by phagocytosis had a similar effect. It was suggested that in atherosclerotic lesions intracellular lipid accumulation and other stimulators of phagocytosis may provoke the expression of macrophage-associated antigen CD68 in settled cells of the subendothelial intima of human aorta.