Lipid synthesis was measured in cultured skin fibroblasts obtained from normals and patients with Hyperapobetalipoproteinemia (HyperapoB). Using lipoprotein-deficient serum medium, triglyceride synthesis and cholesterol esterification were greater in normals than in HyperapoB due to differences in de novo synthesis, not to differences in re-esterification or to different rates of hydrolysis. When normal and HyperapoB cells were incubated in serum-free medium, however, lipid synthesis was the same. Serum was then fractionated chromatographically and a partially purified protein fraction shown to be responsible for the stimulatory effect in normals.