Oxidized LDL, not the native LDL, promotes atherosclerosis. However, ox-LDL is usually undetectable in the blood circulation. Autoantibodies against ox-LDL (gamma ox-LDL), on the other hand, are not only measurable in the blood but may also reflect the extent of in vivo oxidation of native LDL and provide any early sign of risk for atherosclerosis. Current assay for gamma ox-LDL needs improvement. Routine clinical application of this assay has to wait until all parameters of this assay are defined and characterized.