In 20 hypertriglyceridemic normocholesterolemic patients, mean age 51 years (range 42–62), ± 10% ideal body weight, and in 18 normolipidemic controls, mean age 49 years (range 41–63), ± 10% ideal body weight, the following tests were performed: spirometry, flow-volume curves, arterial blood gases, alveolo-capillary transfer of CO, alveolo-arterial gradients of O2 and arterio-alveolar gradients of CO2. A significant decrease in the arterial partial pressure of O2 and in the transfer of CO, with a significant increase in the alveolo-arterial gradient of O2 were found. Hypertriglyceridemia seems to compromise the alveolo-capillary gas exchange.