Cholesterol plays an important role in atherogenesis. Oxidized low-density lipoprotein cholesterol is harmful to arteries whereas high-density lipoprotein cholesterol appears to have beneficial properties on vascular function. There is increasing evidence that inflammation is also involved in the atherogenic process. Inflammation accelerates atherosclerosis and promotes thrombogenesis, and inflammatory biomarkers have been correlated with cardiovascular risk. There is now evidence that lowering low-density lipoprotein and raising high-density lipoprotein cholesterol have beneficial effects on inflammation that might contribute to the reduction in clinical cardiovascular events with currently available lipid-altering therapies. New therapeutic strategies are being designed to inhibit specific aspects of the inflammatory system that contribute to the initiation and progression of atherosclerosis.