This section includes three cases with challenging lipid management. Lipids and lipoproteins are often viewed separately in atherosclerosis or pancreatitis risk assessment but an understanding of lipid and lipoprotein physiology is required to understand fully the basis for thoughtful management. It’s been more than half a century since John Gofman focused our attention on lipoproteins that were defined by their physical and chemical characteristics in the analytical ultracentrifuge. Further work at the National Institutes of Health by researchers such as Don Fredrickson, Richard Havel, Robert Levy, and Dan Steinberg enlarged our understanding of the structure and function of lipoproteins and their relationship to atherosclerosis and hypertriglyceridemic pancreatitis.