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The review is devoted to modern views on hypertriglyceridemia (HTG) etiology and pathogenesis, and its casual role in some disease development. Data on normal TG metabolism, main causes of HTG, its clinical role and diagnostics are discussed. Even though HTG plays an important role in atherosclerosis, pancreatitis, Alzheimer disease, pre-eclampsia development, it is still inadequately described, from clinicians’ point of view.