Choline phospholipids have long been recognized as important structural components of membranes. There is a growing body of evidence that some choline phospholipids (phosphatidylcholine, sphingomyelin, plasmalogens, and their metabolites) also are important mediators and modulators of transmembrane signaling. Another choline phospholipid (platelet activating factor) is an important intercellular messenger acting on leukocytes, platelets, smooth muscle cells, liver, uterus, and the central nervous system. These functions may explain how choline phospholipids, such as lecithin, influence normal physiological processes as well as a diverse group of pathological processes, including cancer and Alzheimer's disease. Recent findings on the molecular actions of choline phospholipids were presented by leading experts in the field at a conference sponsored by the University of North Carolina and held in conjunction with the annual meeting of American Institute of Nutrition in April 1992. This review provides general background on choline and phospholipids in nutrition, metabolism, and signal transduction, and highlights the findings presented at this conference.