This presentation covers lipoprotein metabolism in pregnancy; pre-eclampsia; disorders of LDL metabolism; and, disorders of triglyceride-rich lipoproteins. Speaking at the Physician’s Update Conference in Cape Town during February 2018, Professor Blom begins his presentation by looking at lipoprotein metabolism in pregnancy and the lipid values over the three trimesters and port partum. He discusses HDL cholesterol during the three trimesters; triglycerides during the three trimesters; and pregnancy reference values. Blom briefly looks at the bio-chemistry. He discusses the link of pre-eclampsia and links to cardiovascular risk later in life with hyperlipidaemia being a risk factor for both pre-eclampsia and cardiovascular disease. He discusses lipids in pre-eclampsia. Blom presents information on LDL disorders, including familial hypercholesterolaemia; and, gene dose effect. He discusses the heterozygous fenotype and looks at guidelines before conception. He also discusses changes in the approach to therapy which is now recommended from age 8-12 onwards for children with heterozygous FH. Blom presents information on patients with familial hypercholesterolaemia who are planning a pregnancy and for those with unplanned pregnancies. He examines the teratogenicity of statins and the bases for this, adding that data is not very good with no clear signal of foetal harm or if statins are definitely safe. He discusses statins and breastfeeding. Blom also discusses homozygous FH during pregnancy. He talks about lipoprotein apheresis and the fact that most patients in SA do not have access to this. Blom provides information on a compilation of data of pregnancy experience in SA in patients with homozygous FH and he discusses treatment. Blom briefly discusses patients with HoFH and cardiovascular disease. He talks about hypertriglyceridaemia and acute pancreatitis and briefly discusses the aetiology of HyperTG. Blom concludes by discussing the management of FCS.