Technical Abstract: Most of the data collected on the relationship between alcohol intake and blood lipid concentrations is from cross-sectional or longitudinal surveys. These studies provide much qualitative data but often are confounded with cultural and lifestyle changes that coincide with differences in alcohol intake. The clustering of dietary habits would indicate that the assessment of alcohol-induced changes in population studies is difficult due to changes in a number of other dietary variables. In many alcohol intervention studies, the subjects are free-living with no dietary restrictions. Clearly, dietary fat, fatty acids, carbohydrate, and other components have a significant influence on circulating cholesterol and triglyceride concentrations. All these factors contribute to the inconsistencies observed in the response to alcohol. However, after three decades of research on the relationship between alcohol and blood lipids a fairly clear picture has emerged. Moderate alcohol consumption may have little impact on circulating triglyceride concentration in individuals with triglyceride concentration in the normal range, but clearly lowers LDL-C and raises HDL-C concentrations. There is still some question whether there is an effect of alcohol consumption on apoB concentration. If there is an effect it seems to be small. Changes in sub fractions of HDL are due to increases in both apoA-I and II and appear to be alcohol-dose dependant. The increase in HDL-C and decrease in LDL-C is consistent with the observed decrease in risk of CHD. Although, alcohol consumption has been shown to affect other risk factors for CHD it is clear much of the reduction in risk of CHD is a consequence of the effect on blood lipids.