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OBJECTIVE: The purpose of this study was to evaluate HDL-C values and their relationship to high total cholesterol values during childhood. PATIENTS AND METHODS: We have studied 4,547 children and adolescents of both sexes between 4 and 6 years of age. RESULTS: We found HDL-C values > 50, 65 and 75 mg/dl in 66.28%, 26.17% and 7.81%, respectively. Of the cases studied, 44.8% had TC > 174.9 mg/dl and 15.17% higher than 199.9 mg/dl. The positive predictive value (PPV) to detect LDL-C > 129.9 mg/dl was 67.1 and 26.4 for values of TC > 199.9 and 174.9, respectively. The PPV to detect a LDL-C/HDL-C > 2.19 of the TC > 199.9 and 174.9 mg/dl was 54.78 and 23.95, respectively. CONCLUSIONS: The HDL-C of children and adolescents is often high and this could be responsible for the high TC values. Most of the children with TC values between 174.9 and 199.9 mg/dl have neither an increase in LDL-C nor in the LDL-C/HDL-C ratio.