In youth, high triglycerides(TGs) usually occur with low HDL-cholesterol(HDL-C) as combined dyslipidemia(CD) in the context of obesity. This is now the predominant dyslipidemic pattern in childhood, seen in 30 to 60 % of obese individuals. In adults, CD is the most common lipid pattern seen with premature coronary disease. At the lipid subpopulation level, hypertriglyceridemia and CD are represented as increased LDL particles and small, dense LDL plus reduced total HDL-C and large HDL, a highly atherogenic pattern. Hypertriglyceridemia and CD in childhood predict vascular dysfunction and pathologic evidence of atherosclerosis in adolescence, and early clinical cardiovascular events in adult life. Moderate hypertriglyceridemia and CD are highly responsive to lifestyle change and the evidence supporting weight loss, change in diet composition, and increased activity as effective treatment is used to develop recommendations for management. Drug treatment is rarely indicated, reserved for the adolescent with multiple additional high-level risk factors after intensive long-term efforts at lifestyle modification.