Many HIV-infected patients have dyslipidemia and other cardiovascular risk factors prior to acquiring infection. Both HIV infection itself and antiretroviral therapy can cause or worsen lipid abnormalities. Management of dyslipidemia in the HIV-infected patient requires awareness of the effects of antiretroviral agents on lipid profiles, including potential sex- and race-related effects, and interactions between lipid-modifying agents and antiretroviral agents. This article uses individual case histories to illustrate the decisions encountered in treating HIV infection and dyslipidemia. The article is based on a presentation on management of dyslipidemia and other cardiovascular risk factors in HIV infection made by Judith A. Aberg, MD, at the International AIDS Society-USA Los Angeles CME program in February 2006.