Background/Objectives: Consumption of hydroxypropylmethylcellulose (HPMC), a viscous dietary fiber, lowers total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). However, HPMC had not previously been studied in individuals receiving lipid drug therapy. Subjects/Methods: This randomized, double-blind crossover trial examined the lipid effects of HPMC in subjects with hypercholesterolemia on statin therapy. Men (n ¼ 5) and women (n ¼ 8) with LDL-CX2.59 mmol/l after at least 4 weeks of stable-dose statin therapy, and a mean age of 58.6 years, were enrolled. Subjects received twice daily doses of either 2.5 g HPMC or control, delivered in a lemonade beverage for 4 weeks, then crossed over to receive the opposite treatment for an additional 4 weeks. Results: Mean baseline concentrations of TC, non-high-density lipoprotein cholesterol (non-HDL-C), LDL-C, HDL-C, triglyceride (TG), TC/HDL-C ratio and apolipoprotein (Apo) B were 4.95, 3.63, 3.03, 1.33, 1.30 and 3.89 mmol/l and 1.00 g/l, respectively. HPMC consumption resulted in significantly larger reductions (Po0.01 vs control for all) in TC (À10.9 vs À3.5%), non-HDL-C (À12.8 vs À2.9%), LDL-C (À15.7 vs À5.1%), TC/HDL-C ratio (À5.3 vs þ 1.3%) and Apo B (À8.7 vs À3.9%). There were no differences between treatments for changes in HDL-C (À5.2 vs À4.3%) or TG ( þ 3.9 vs þ 8.9%). Conclusions: These results support the view that HPMC is an effective adjunct to statin therapy for further lowering atherogenic lipids and lipoproteins in men and women with primary hypercholesterolemia.