Despite the considerable advances in medicine related to the diagnostics and management of atherosclerosis, mortality from the associated diseases remains rather high. This stimulates the continual search for new targets for therapeutic intervention. It becomes increasingly clear with the advent of the novel modern high-tech research methods that one of the most promising directions in the therapy of atherosclerosis is the impact on the selected stages of intestinal lipid metabolism and on the intestinal microbiota. The pathological changes in the composition and function of intestinal microflora are known to occur in 90% of the patients suffering from cardiovascular diseases. It is known that a basic process underlying cholesterol homeostasis is enterohepatic cholesterol circulation. The knowledge of the specific features of lipid metabolism beginning from absorption in the intestine and liver biosynthesis up to excretion with bile, makes it possible to better understand the important role played by the digestive system in the development of dyslipidemia.