The influence of cortisol, in the presence of insulin, on the regulation of lipoprotein lipase (LPL) activity was studied in human adipose tissue, using a tissue incubation technique. Tissue pieces were preincubated for 3 days in a control medium containing insulin (7175 pmol/L), then incubated for 2 additional days in the control medium with and without cortisol (1000 nmol/L). After the 5 days of incubation, the levels of LPL messenger ribonucleic acid (mRNA), relative LPL synthesis, and LPL activity (total and heparin releasable) were studied. Cortisol exposure for 2 days increased all of the variables related to LPL. The average increase was 2.5-fold for LPL mRNA, 3.0-fold for relative LPL synthesis, 5.2-fold for total LPL activity, and 9.4-fold for heparin-releasable LPL activity compared to that in controls without cortisol. The results confirm previous findings that cortisol, in the presence of insulin, has a marked stimulatory effect on LPL activity in human adipose tissue in vitro. New data have been presented on the mechanisms of cortisol regulation of LPL activity. They involve both an increased level of LPL mRNA, leading to increased relative LPL synthesis, and additional posttranslational regulation.