A reduction in serum total cholesterol (T-C) levels has been shown to reduce mortality in patients with coronary artery disease and to decrease the need for revascularization. To examine the prevalence and treatment of lipid disorders in patients referred for their first coronary angiogram, medical history and fasting blood samples were collected in 108 consecutive patients. Ninety-one patients (84.3%) fulfilled the criteria for dyslipidemia. Hypercholesterolemia had previously been demonstrated in 53 patients (49.1%), and 34 (64.2%) of these patients still had T-C > 6.0 mmol/l at the time of admission. Among 55 patients who were unaware of any lipid disorders at admission, 28 (50.9%) had T-C > 6.0 mmol/l. Conclusion: the majority of patients referred for their first coronary angiogram and possible revascularization suffered from dyslipidemia. Many patients with previously recognized dyslipidemia were insufficiently treated.