Nitric oxide can have both pro-oxidant and antioxidant effects on low-density lipoprotein. Nitric oxide does not appear to react directly with components of LDL. However, in the presence of oxygen (through NO2 and N2O3 formation) or superoxide (through peroxynitrite formation) nitric oxide may cause oxidation of the lipid, protein and antioxidant components of LDL. Conversely, nitric oxide is a potent inhibitor of LDL oxidation when initiated by copper ions or by azo-initiators. The possible implications of these observations to vascular pathology are discussed.