Dyslipidemia is recognized as a significant risk factor for atherosclerotic disease. There has been a great deal of progress in the detection and management of dyslipidemia, but challenges remain, including whether to treat children, adolescents, and the elderly. Challenges include convincing physicians who tend to manage an outpatient disease with a single therapy that the management of cardiovascular risk and disease often requires multiple therapies, describing how we can combine therapies to provide an additive benefit without adding side effects or increasing morbidity, and determining whether a patient with one or more cardiovascular risk factors but a normal lipid should receive lipid-lowering therapy. Finally, there is the challenge of the Human Genome Project and predictive medicine. How will genetic information be integrated into the practice of medicine for disease prevention and management?