The lysosphingolipid sphingosine 1-phosphate (S1P) is a component of HDL. Findings from a growing number of studies indicate that S1P is a mediator of many of the cardiovascular effects of HDL, including the ability to promote vasodilation, vasoconstriction, and angiogenesis, protect against ischemia/reperfusion injury, and inhibit/ reverse atherosclerosis. These latter cardioprotective effects are being shown to involve the S1P-mediated suppression of inflammatory processes, including reduction of the endothelial expression of monocyte and lymphocyte adhesion molecules, decreased recruitment of polymorphonuclear cells to sites of infarction, and blocking of cardiomyocyte apoptosis after myocardial infarction. This review article summarizes the evidence that S1P as a component of HDL serves to regulate vascular cell and lymphocyte behaviors associated with cardiovascular (patho)physiology. (1) were the first to show that the lysosphingolipid sphingosine 1-phosphate (S1P) was a component of human plasma, present at a concentration of ?200 nM. After these findings were published, Sachinidis et al. (2) reported that human LDL and HDL possess a signaling activity that promoted extracellular signal-regulated protein kinase phosphorylation in a pertussis toxin-sensitive manner. HPLC fractionation of plasma LDL and HDL showed that the lipoproteinassociated signaling activity had a chromatographic elution profile corresponding to that of purified S1P. Further evidence appeared demonstrating that ?65% of the S1P in blood is associated with the lipoproteins LDL, VLDL, and HDL, with the bulk of lipoprotein-associated S1P (?54%) bound to HDL (3). Measurements of the S1P content of human HDL and LDL particles show that these lipoproteins contain ?180 and 70 pmol S1P/mg protein, respectively (4). Together, these findings have set the stage for investigations into the mechanism of S1P incorporation into lipoproteins and the physiological significance of lipoproteins as carriers of S1P, and the findings of these investigations are summarized in this review.