Human hepatic lipase (hHL) plays an important role in hydrolysis of triglycerides from plasma lipoproteins. The enzyme also hydrolyzes HDL2 lipids resulting in smaller HDL particles with a lower cholesterol content and properties similar to HDL3. hHL is localized in liver sinusoids, ovary and adrenal gland. These findings propose an influence on processing of cholesterol. Here we report an insertion mutation in exon 3 of hHL. The 18 bp duplication contains an additional internal point mutation (GenBank-Accession #AF037404). The female mutation carrier suffered from severe adiposity with total cholesterol of 291,6mg/dl, HDL-cholesterol of 55,3mg/dl, LDL-cholesterol of 206,8mg/dl and triglycerides of 80,8mg/dl. Following cloning of a PCR-amplified fragment the mutation was confirmed by cycle sequencing. Sequence analysis revealed an inserted repeat of 18 nucleotides. Furthermore the patient carries an additional missense mutation A-->G at nucleotide 9 of the repeat which results in an amino acid exchange from Ile-->Val at codon 4 of the repeat. These data enable us to report the insertion of HisTyrThrValArgVal which might be responsible for the moderate shift in lipid metabolism of the heterozygous patient.