Drinking alcohol has multiple effects on lipoprotein metabolism that lead to alterations, such as low levels of LDL and lipoprotein (a) and high levels of HDL. The protective effects of alcohol against coronary heart disease may be partly mediated by these lipoprotein changes. This review will focus mainly on the mechanisms potentially responsible for the alcohol-induced alterations in lipoprotein metabolism. Some common pitfalls in alcohol studies will also be discussed.