The cardiac lymphatics are responsible for the transport of all the lipoproteins and cholesterol from the extravascular myocardial tissue, although little is known about the filtration and lymphatic clearance of the coronary artery wall. It is postulated that a critical factor in the genesis of arteriosclerosis is lymphstasis, which adequately explains the positive correlation with the known risk factors for coronary artery disease and the negative correlation with high-density lipoproteins. Further research is necessary in this little-known area to better understand the etiology of atherosclerosis.