SummaryWe investigated whether pre-germinated brown rice bran extract containing acylated steryl glucosides (PSG) reduces the risk of atherosclerosis in post-menopausal Vietnamese women. A total of 60 post-menopausal Vietnamese women (45-65 y old) with high LDL cholesterol levels (over 140 mg/dL) were randomly divided into PSG (n530) and placebo (n530) groups. The subjects in the PSG group were assigned a daily intake of 6 capsules containing 50 mg PSG, and the subjects in the placebo group were assigned a daily intake of 6 capsules containing corn oil for 6 mo. Before baseline and after month 2, month 4, and month 6 of the intervention, we conducted anthropometric measurements, blood biochemical examinations, a nutrition survey, and physical activity, flow-mediated dilation (FMD), and cardio-ankle vascular index (CAVI) measurements. Serum LDL cholesterol concentrations were significantly reduced from 163.6625.3 (mg/dL) to 135.9626.8 (mg/dL) compared to the placebo group (p,0.001). FMD values of the placebo group were significantly reduced from 6.665.1 (%) to 4.762.6 (%) compared to the PSG group (p,0.05). Tumor necrosis factor (TNF)-a concentrations in the PSG group were significantly reduced from 19.8611 (pg/mL) to 10.665.5 (pg/mL) compared to the placebo group (p,0.05). The findings suggest that PSG may improve LDL cholesterol, TNF-a levels, and FMD values. PSG might be considered in reducing the risk of atherosclerosis in post-menopausal Vietnamese women with high LDL cholesterol.