Fibrates are a widely used class of hypolipidemic drugs. The effects of fibrates are mediated through the activation of the transcription factor peroxisome proliferator-activated receptor a (PPARa). Fibrates act to modulate the transcription of genes that encode proteins controlling lipid transport and metabolism. Fibrates also exert pleiotropic anti-inflammatory effects by down regulating expression of genes encoding inflammatory cytokines and acute phase response proteins. These combined actions translate into clinical benefit as demonstrated by the reduction in cardiovascular morbidity and mortality in primary and secondary intervention trials.