Hypercholesterolaemia is a metabolic disorder characterized by elevated total and LDL-cholesterol levels. Patients with hypercholesterolaemia are at high risk for coronary artery disease, and current guidelines recommend treatment for patients with elevated total or LDL-cholesterol levels. Fenofibrate is a fibric acid derivative that has been available in much of the world for over 10 years. In controlled and comparative clinical trials, fenofibrate has been shown to lower significantly plasma levels of total and LDL-cholesterol as well as plasma triglycerides. In addition, fenofibrate is associated with a relatively low incidence of adverse effects with some gastro-intestinal, dermatological and musculoskeletal reactions. Based on its efficacy and tolerability profile, fenofibrate would appear to be an appropriate choice for treatment of hypercholesterolaemia in selected patients.