Triglycerides (TGs) are now considered an independent risk factor for cardiovascular disease (CVD). When TGs are elevated, lipoprotein metabolism is altered, which increases CVD risk. Patients with elevated TGs and low high-density lipoprotein are at particularly high risk of CVD. TGs are often associated with other CVD risk factors, such as obesity, insulin resistance, diabetes mellitus, low HDL cholesterol, lifestyle factors, and changes in lipoprotein size and density. Elevated TGs remain an independent risk even when controlling for the other factors and are a greater risk for women than men. Treatment of elevated TGs in clinical trials has been shown to reduce CVD events, cardiac deaths, and total mortality.