Xanthelasma palpebrarum was studied in 896 patients seen at the Mayo Clinic between 1950 and 1961. Although this condition may be a sign of underlying systemic disease such as essential familial hypercholesteremia, it is a distinct xanthomatous disorder that commonly occurs alone. Associated primary diagnoses of hypertension, obesity, and heart disease were recorded for 165 men and 241 women. The percentage of xanthelasma with hypercholesterolemia in all age groups over 30 was equal. The incidence of other xanthomatous processes was only 2.2% in the men and 1% in the women.