To evaluate the importance of peroxisomes in cholesterol metabolism we measured the rate of cholesterol synthesis in cultured skin fibroblasts from 16 patients in whom deficiency of peroxisomes had been established. Seven complementation groups were studied, consisting of one six member group, one three member group, three groups comprising single cases and two groups with two cases each. On the average, cholesterol synthesis was below control values in all the 16 peroxisome-deficient fibroblast cell cultures. The range of cholesterol synthesis in these cells was 2% to 84% of normal values. These data strongly suggest that peroxisomes are essential for normal cholesterol synthesis in human fibroblasts.