This article gives practical guidance to those relatively unacquainted with the task of managing hyperlipidaemia. It primarily addresses doctors but can be easily read by a wider audience. Management starts with assessing the individual risk, which can be done without difficulty for men aged between 35 and 65 years. If the individual has a total serum cholesterol level between 6.0 and 7.8 mmol/L, their risk may be more precisely estimated after measuring serum high density lipoprotein cholesterol level and considering smoking status, blood pressure and signs of manifest arteriosclerotic disease. An algorithm for this is suggested. In addition, family history concerning early cases of coronary disease should be considered. Advice is then given for evaluating risks for women and for the elderly. Finally, data from the literature concerning cost effectiveness and burden of illness are summarised.