The misfolding and self-assembly of proteins into amyloid fibrils that occurs in several debilitating and age-related diseases is affected by common components of amyloid deposits, notably lipids and lipid complexes. We have examined the effect of the short-chain phospholipids, dihexanoylphosphatidylcholine (DHPC) and dihexanoylphosphatidylserine (DHPS), on amyloid fibril formation by human apolipoprotein C-II (apoC-II). Micellar DHPC and DHPS strongly inhibited apoC-II fibril formation, whereas submicellar levels of these lipids accelerated apoC-II fibril formation to a similar degree. These results indicate that the net negative charge on DHPS, compared with the neutrally charged DHPC, is not critical for either the inhibition or activation process. We also investigated the mechanism for the submicellar, lipid-induced activation of fibril formation. Emission data for fluorescently labeled apoC-II indicated that DHPC and DHPS stimulate the early formation and accumulation of oligomeric species. Sedimentation velocity and equilibrium experiments using a new fluorescence detection system identified a discrete lipid-induced tetramer formed at low apoC-II concentrations in the absence of significant fibril formation. Seeding experiments showed that this tetramer was on the fibril-forming pathway. Fluorescence resonance energy transfer experiments established that this tetramer forms rapidly and is stabilized by submicellar, but not micellar, concentrations of DHPC and DHPS. Several recent studies show that oligomeric intermediates in amyloid fibril formation are toxic. Our results indicate that lipids promote on-pathway intermediates of apoC-II fibril assembly and that the accumulation of a discrete tetrameric intermediate depends on the molecular state of the lipid.Amyloid fibrils are formed by the self-assembly of naturally occurring proteins that misfold and aggregate into structures that share a number of common properties. The defining characteristics include increased -structure compared with the native form of the protein, a fibrillar cross--morphology, and the ability to interact with the dyes thioflavin T and Congo Red (1). The presence of specific fibrils in amyloid deposits associated with common neurodegenerative diseases, including Alzheimer and Parkinson diseases, has drawn considerable attention to the factors that affect amyloid fibril formation and the role of these fibrils in disease. Several factors within amyloid plaques exert effects on fibril formation, including metal ions, glycosaminoglycans, and proteins, such as serum amyloid P and apolipoprotein E (2). One important factor is the presence of lipids and lipid complexes, which are common components of all amyloid deposits. Fibrillogenesis by the A 2 peptide (3), ␣-synuclein (4), or the islet amyloid polypeptide (5) is increased significantly by phospholipids in a manner that depends on the net charge of the phospholipid. Lipid bilayers composed of negatively charged phosphatidylserine or other anionic phospholipids accelerate amyloid fib...