OBJECTIVE The increasing incidence of obesity and diabetes worldwide are critical risk factors for the development of cardiovascular disease. Although the role of the central nervous system (CNS) in the control of fat mass and glucose metabolism has been studied in detail, less is known about the contribution of neural-derived signals in the development of systemic dyslipidemia. In this review we summarize and analyze evidence suggesting a specific role of the CNS in the control of systemic cholesterol metabolism and circulating plasma lipids levels. RESULTS Although early reports based in lesions or electrical stimulation suggested a role for CNS-derived signals in the development of dyslipidemia, more recent findings have confirmed the involvement of specific neural pathways critical for the neuroendocrine control of cholesterol metabolism and plasma lipid levels. CONCLUSIONS The identification of the pathways targeted by the CNS to control plasma lipid levels could offer alternative targets to create efficient novel therapies for the treatment of several metabolic syndrome components including dyslipidemia.