We compared the 16-hour-standing plasma test to lipoprotein electrophoresis on agarose gel for detection of chylomicrons in 129 patients' samples with triglyceride values greater than or equal to 4.00 g/L. Chylomicrons were observed in 12 samples (9.3%) by use of the standing-plasma test and in 58 samples (45.0%) by use of agarose-gel electrophoresis. Thus the standing-plasma test did not detect chylomicrons in 46 samples where they were observed by electrophoresis, or 79.3% of all cases where chylomicrons were present. Chylomicronemia was missed in the presence of lower triglyceride concentrations as well as at very high ones. We recommend that lipoprotein electrophoresis be routinely performed on plasma of patients with triglycerides concentrations greater than 4.00 g/L to distinguish between types IV and V hyperlipoproteinemia, as well as to detect failure of a patient to fast before sample collection.