The case of rear complicated homozygous hypercholesterolemia treated by a direct adsorption of lipoprotein apheresis procedure is presented in this article. In total, 30 sessions of direct adsorption of lipoprotein apheresis were performed on a 14-16-year-old patient from June 2004 to December 2006. Blood flow rate was 30-70 mL/min. Central and ulnar veins were punctured. Lipid levels were measured before and after lipid apheresis during each session throughout the study period. The mean decrease in total cholesterol level was 26.4-71.2% compared to baseline, low-density lipoprotein cholesterol--31.9-72.2%, lipoprotein (a)--56.6-90.9%, apolipoprotein B--26.4-60.0%. Clinical procedures were completely uneventful. The last 26 sessions were performed in a day unit.