This study examined the relationship between serum lipid activity in healthy Type A men and cardiovascular and neuroendocrine responses to a behavioral stressor, mental arithmetic. Assessment of blood lipids included measures of total cholesterol (TC), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), and serum triglycerides. Cardiovascular (blood pressure and heart rate) and neuroendocrine (epinephrine, norepinephrine and cortisol) responses were recorded before (rest), during (stress) and after (recovery) the mental arithmetic test. Diastolic blood pressure, mean arterial pressure and, to a lesser extent, systolic blood pressure levels at rest, during stress, and at recovery correlated positively with TC levels. In addition, both diastolic and mean arterial pressure were positively correlated with the ratio of TC to HDLC and with triglycerides during stress and recovery. Heart rate did not correlate with any lipid measure. Cardiovascular stress-reactivity calculated as change from rest to stress did not correlate significantly with any lipid measure. Plasma norepinephrine during stress correlated positively with triglycerides; a similar trend was observed for the TC/HDLC ratio. Plasma cortisol at rest and during stress correlated positively with the TC/HDLC ratio and serum triglycerides, and negatively with HDLC. Plasma norepinephrine reactivity calculated as change from rest to stress correlated negatively with HDLC and positively with triglycerides. In addition, cortisol reactivity was positively correlated with triglycerides. It is suggested that the mechanisms mediating Type A behavior and coronary heart disease may include increased cardiovascular and neuroendocrine responses as well as unfavorable lipid profiles.