The endothelium is a physical barrier between the blood and vascular smooth muscle, a source of enzymes activating and deactivating cardiovascular hormones and a site of production of relaxing and contracting factors. Nitric oxide is a potent vasodilator and inhibitor of platelet function which under most circumstances is released together with prostacyclin which exerts similar effects. Both substances play an important protective role in the coronary circulation in that they cause continuous vasodilation and inhibition of platelet function. In addition, the endothelium is a source of contracting factors such as endothelin-1, thromboxane A2 and endoperoxides. Due to its strategic anatomic position, the endothelium is a primary target of injuries and cardiovascular risk factors. Besides other risk factors such as hypertension and diabetes, low density lipoproteins alter endothelial function. A reduced release of endothelium-derived relaxing factors and an enhanced liberation of endothelium-derived contracting factors are common in the presence of lipoproteins. These alterations in endothelial function are likely to contribute to the pathogenesis as well as progression and complications of coronary artery disease such as vasospasm and thrombus formation. This review will focus on the influence of lipoproteins on endothelial function.