Endotoxins (lipopolysaccharides, LPS) are biologically active substances present in the outer membrane of gram-negative bacteria. They induce a spectrum of biological effects which may be harmful or beneficiary for the host. Lipid A is the biologically active part of the LPS molecule. This was demonstrated using soluble forms of lipid A and more recently confirmed further by employing synthetic lipid A. LPS administered into experimental animals circulates as LPS/HDL complex and is cleared from the blood mainly into the liver and spleen. In the liver LPS undergoes partial deacylation however without a loss of toxic activity. Its excretion is effected mainly via the bile into the gut. The lethal toxicity and tolerance inducing properties of LPS are mediated by macrophages through tumor necrosis factor alpha (TNF alpha), which is probably the most important endogenous mediator of the lethal effects of LPS. The lethal toxicity of LPS may be completely inhibited by anti-TNF alpha antibodies.