High blood cholesterol (HBC) (i.e., total cholesterol > or =240 mg/dL) is a major risk factor for heart disease, the leading cause of death in the United States. As a result, public health agencies and their partners have attempted to reduce the prevalence of HBC through screening and by increasing public awareness of HBC and strategies for reducing it. A national health objectives of Healthy People 2010 is to increase to 80% the proportion of adults aged > or =20 years who have been screened for HBC within the preceding 5 years. For this report, data from the Behavioral Risk Factor Surveillance System (BRFSS) collected during 1991-2003 were analyzed to examine trends in the percentage of adults screened for HBC and the percentage of those screened who were told they had HBC. The findings indicated that both percentages increased during 1991-2003 but that few states had achieved the national health objective for screening. Further emphasis on cholesterol screening is needed, particularly among Hispanic and Asian/Pacific Islander populations and young adults.