A case showing the regression of coronary atherosclerosis by the treatment with LDL-apheresis, was reported. The patient was a 67-year old female with heterozygous familial hypercholesterolemia. She had noticed the xanthelasma or left cubital xanthoma at the age of 50 years old. She was informed about her high serum cholesterol level (greater than 350 mg/dl), and the abnormal thickness of her bilateral achilles tendon at the age of 61 years. As her serum cholesterol level did not decrease sufficiently with several lipid-lowering drugs, she was referred to our hospital in order to obtain treatment for it by LDL-apheresis at the age of 66 years. LDL-apheresis was performed once every two weeks with drugs such as probucol, cholestyramine and pravastatin. Her coronary angiogram after two and half years of LDL-apheresis showed a decrease of the coronary narrowing in segment 1 and segment 13 (from 96.8% to 74.6% in segment 1, and from 81.5% to 61.7% in segment 13, respectively). The thickness of her bilateral achilles tendons had also decreased from 18 mm in the right and 19 mm in the left to 14 mm in both, after receiving LDL-apheresis for two and half years. It is suggested from the result of this case that the regression of coronary atherosclerosis could be expected after treatment with LDL-apheresis in hypercholesterolemic patients.