The role of endothelial cells (EC) in the development and progression of early swine intimal cell mass (ICM)-derived coronary artery lesions in 55 swine fed either a mash or hyperlipidemic diet for 14, 49 or 90 days was investigated. Characteristics studied were endothelial cell turnover (using tritiated thymidine autoradiography), adhesion of leukocytes (presumably chiefly monocytes) to endothelium, and the presence or absence of endothelial cell denudation. The major findings were: An increased adherence of leucocytes to endothelial cells over ICM-lesions in the HL-90 day group compared to the corresponding mash value at 90 days as well as to that of each of the other HL and mash groups. Significant positive correlation between the labeling indices (LI) of endothelial cells lying over coronary artery lesion cells and the labeling indices of the underlying ICM-lesion cells; also, a significant positive correlation between the labeling indices of endothelial cells over lesions of the abdominal aorta and those of the coronary arteries. At 90 days the endothelial cell LI over lesions in the HL group was significantly higher than the corresponding values in the mash group. Since the EC increase rates by growth in the two groups are also significantly different, the differences in LIs reflect at least in part EC growth differences and no strong conclusion can be made regarding possible cell turnover differences. No frank endothelial denudation was found. The findings suggest that in swine coronary arteries participation by monocytes from circulating blood is a factor in the early progression of the lesion as well as smooth muscle cell proliferation.