The purpose of this study was to determine the effect of chronic angiotensin II (AngII) infusion on the severity of the atherogenic process in low density lipoprotein (LDL) receptor -/- mice with established lesions. LDL receptor -/- mice receiving a diet enriched in cholesterol, saturated fat, and cholate, were infused with saline or AngII (500 ng/kg/min) for 28 days. Systolic blood pressure increased in LDL receptor -/- mice following 7 days of AngII infusion, followed by a decline to baseline levels at 28 days, despite continued AngII infusion. Serum cholesterol was not influenced by AngII infusion in LDL receptor -/- mice; however, serum triglyceride concentrations were reduced significantly in LDL receptor -/- mice receiving AngII. The percent of intimal surface area covered by lesion was not increased in LDL receptor -/- mice receiving AngII; however, the content of cholesterol (esterified and unesterified) in lesions of the arch, thoracic, and abdominal aorta was significantly increased in those mice infused with AngII. Of note, in 20% of the LDL receptor -/- mice receiving AngII, large aneurysms were found in the abdominal aorta. Aneurysms appeared as breaks in the media and surrounding tissue of the vessel wall, encompassing amorphous and acellular masses with patches of thrombotic material. These results demonstrate that chronic infusion of AngII promotes the atherogenic processes in LDL receptor -/- mice, manifest as increases in lesion cholesterol content. Effects of AngII to promote atherogenesis were apparent at doses which did not markedly elevate systolic pressure. Importantly, infusion of AngII in LDL receptor -/- mice resulted in the development of aortic aneurysms.