The case of rare complicated homozygous hypercholesterolemia treated by a direct adsorption of lipoprotein apheresis procedure is presented in this article. In total eight sessions of direct adsorption of lipoprotein apheresis were performed on 14-year-old patient from June 2004 to January 2005. Blood flow rate was 30-50 ml/min. Central or ulnar veins were punctured. Lipids levels before and after lipid apheresis were measured during each session throughout the study period. The mean decrease in low-density lipoprotein cholesterol levels was 34.3-52.6% compared to baseline, total cholesterol--26.4-49.1%, lipoprotein (a)--67.4 and 90.9%, apolipoprotein B--26.4 and 48.4%. No side effects and complications were observed. The last four sessions were performed in a day unit.