Recently, there has been a renewed interest in the possibility that abnormalities in lipid metabolism may be important in the pathogenesis of glomerulosclerosis. Hyperlipidemia participates in the development and progression of vascular injury commonly associated with atherosclerosis. Several studies have shown that glomerular injury occurs with diet-induced hyperlipidemia. Recent investigations have also suggested that endogenous abnormalities in lipid metabolism cause glomerular damage. The importance of defining the precise role of lipid abnormalities in the pathogenesis of glomerulosclerosis is underscored by the almost invariable presence of hyperlipidemia in patients with renal disease. This review will focus on the potential role of abnormal lipid metabolism in the pathogenesis of glomerular injury.