The significance of lipid abnormalities as the risk factor for stroke remains uncertain. The aim of this study was to compare the concentrations of lipoprotein (a) [lp(a)] in stroke patients with large and small vessel disease. We studied 71 patients being 3 to 12 months after ischemic stroke (including 30 subjects with large vessel disease and 41 subjects with small vessel disease) and 30 controls. We excluded patients with stroke of cardioembolic, rare or uncertain etiology, subjects with diabetes, with history of myocardial infarction, arrhythmia, valvular heart disease, hypo- or hyperthyreoidism, hepatic or renal insufficiency, and treated with statins or fibrates. We assessed basal lipid fractions and nephelometrically measured the concentration of lp(a). The concentrations of total and LDL-cholesterol were similar in studied groups. Patients with large vessel disease had lower levels of HDL-cholesterol and higher levels of triglycerides than patients with small vessel disease and than controls. Median concentrations of lp(a) were similar in all studied groups (8.4 mg/dl in all stroke patients; 10.85 mg/dl in large vessel disease; 7.7 mg/dl in small vessel disease and 6.3 mg/dl in controls; p = n.s.). The percentage of subjects with increased lp(a) concentrations (i.e. > 30 mg/dl) was greater in large vessel disease (36.7%) than in small vessel disease (12.2%; p < 0.05) and in controls (10%; p < 0.05). The concentrations of basal lipid fractions were similar in subjects with normal and with increased concentration of lp(a), both in stroke patients and in controls.