Plasma apolipoprotein AI, apolipoprotein B, cholesterol and triglycerides in 114 Ivorian patients with homozygous sickle cell anaemia (HbSS) were compared to 40, age and sex matched controls with normal haemoglobin (HbAA). Except for plasma triglycerides, lipid and apolipoprotein levels were found to be lower in patients with sickle cell anaemia as compared to normal control subjects. The differences between the two groups were found to be statistically significant (p < 0.05 Student's t test). In addition, a highly significant decrease of plasma apolipoprotein AI (p < 0.01) was observed during painful crisis as compared to the steady state (0.78 g.L-1 versus 1.01 g.L-1), whereas triglyceride levels were found to be higher (1.02 g.L-1 versus 0.78 g.L-1). Although the metabolism of lipoproteins is being altered, the results of this cross-sectional study do not suggest that patients with sickle cell anaemia are at higher risk of developing coronary artery disease.