This review discusses the importance of chylomicrons and triglyceride-rich lipoproteins (TRL) in atherogenesis, particularly in the postprandial period. It highlights the role of lipoprotein lipase (LPL) and apolipoprotein CIII (apoCIII) in the metabolism of chylomicrons, emphasizing the critical physiological role of these enzymes and proteins. The review also addresses the complexities of testing postprandial metabolism, the role of angiopoietin-like proteins (ANGPTLs) in the partition of chylomicrons during the fed cycle, and the dysregulation of postprandial lipid metabolism in insulin-resistant states. Additionally, it covers the clinical evaluation of postprandial dyslipidemia, current research limitations, and potential future study directions. The review underscores the need to shift the focus from LDL-centric to a more comprehensive understanding of lipid metabolism, especially in the context of atherosclerosis and cardiovascular disease (CVD) risk.This review discusses the importance of chylomicrons and triglyceride-rich lipoproteins (TRL) in atherogenesis, particularly in the postprandial period. It highlights the role of lipoprotein lipase (LPL) and apolipoprotein CIII (apoCIII) in the metabolism of chylomicrons, emphasizing the critical physiological role of these enzymes and proteins. The review also addresses the complexities of testing postprandial metabolism, the role of angiopoietin-like proteins (ANGPTLs) in the partition of chylomicrons during the fed cycle, and the dysregulation of postprandial lipid metabolism in insulin-resistant states. Additionally, it covers the clinical evaluation of postprandial dyslipidemia, current research limitations, and potential future study directions. The review underscores the need to shift the focus from LDL-centric to a more comprehensive understanding of lipid metabolism, especially in the context of atherosclerosis and cardiovascular disease (CVD) risk.