AbstractA local event which occurs after damage of a blood vessel can be the start of cellular cholesterol ester accumulation. Thrombocytes and macrophages will adhere to the endothelial wall. Subsequently lipoproteins and macrophages permeate this endothelial wall. The perivascularly arranged macrophages will internalize the “modified lipoproteins” and eventually cholesterol ester accumulation will take place. This cholesterol ester accumulation can also occur in smooth muscle cells. The reversibility of the accumulation depends on the lipoprotein levels and on the physico‐chemical characteristics of the accumulated cholesterol (esters). This phenomenon takes place in the formation of xanthomas as well as in atheroge