The lipid content and acyl group composition of serum from a group of alcoholic patients at a VA Medical Center were compared to control subjects sampled either from University of Missouri personnel or from subjects who were undergoing a preemployment physical examination at the same VA Medical Center. Plasma of alcoholic patients indicated an elevated triacylglycerol level (24-35%) as compared to both control groups. In addition, the acyl groups of triacylglycerols of alcoholic patients showed a markedly lower proportion of 18:2 and a higher proportion of 18:0 and 18:1 as compared to the control groups. The level of phosphatidylcholines in the plasma of alcoholic patients was not different from controls. However, acyl group composition of phosphatidylcholines from alcoholics indicated a lower proportion of 22:6 (n-3) as compared to controls. Although the cholesteryl ester level in serum was higher in alcoholics than in controls, the difference did not reach a level of significance. There was a similar decrease in 18:2 and an increase in 18:0 in cholesteryl esters of alcoholics as compared to controls. Results indicate that alcoholics in the United States show a similar change in certain serum lipids as reported for the Swedish alcoholics. This study also shows the complexities involved in selecting appropriate control groups to be compared with alcoholic patients.