This study assesses the ability of a blood donor cholesterol screening program to enhance awareness of cholesterol levels among screenees and to promote lifestyle changes and physician follow-up. Beginning in November 1990, all blood donors at the Minneapolis Veterans Affairs Medical Center were offered free cholesterol screening. Each screenee also received educational materials and brief counseling from a nurse. Two weeks after donation, screenees received a postcard with their cholesterol level and information regarding recommended follow-up. Baseline information for all screenees was obtained at the time of donation through a self-administered questionnaire. Follow-up data were collected through structured telephone interviews. During the program's first four months, 1,039 donors (33%) requested cholesterol screening. At baseline, 82.6% of screenees had at least one risk factor for coronary heart disease, and 37% had two or more risk factors. More than one third were unaware of their cholesterol levels. At follow-up, more than 95% indicated that they were aware of their cholesterol levels, and 90% of those with high cholesterol levels had followed up with their physician or made dietary or other lifestyle changes. We conclude that a cholesterol screening and minimal intervention program for blood donors enhances awareness of cholesterol levels and encourages dietary or other lifestyle changes.