Abstract: Objective To investigate the effects of medium-chain triglyceride (MCT) on reverse cholesterol transport in mice with hypercholesterolemia. Methods Thirty mice with hypercholesterolemia induced by feeding high-fat and cholesterol were randomly divided into 2 groups (MCT group and LCT group, n=15), and they were fed high-fat and cholesterol diets with 2% MCT or 2% long-chain triglyceride (LCT), respectively. Three months later, macrophage reverse cholesterol transport (RCT) was assessed by injecting ³H-cholesterol labeled RAW264.7 macrophages intraperitoneally. After 3 days, feces were collected and the body length, liver and epididymides tissues were measured. The serum lipid was measured and the activity of ³H-tracer in serum, liver and feces were determined by liquid scintillation method. Results At the end of study, the body weight, weight gain, liver weight, Lee's index, epididymides fat weight and serum levels of TC were significantly lower in MCT group than those in LCT group (P＜ 0.05), while no significant difference showed in serum levels of HDL-C, n-HDL-C and TG between the two groups (P＞ 0.05). Compared with the LCT group, the ³H-cholesterol in serum and liver were much lower in MCT group (P＜ 0.05), while the total ³H-cholesterols in feces in 3 days experiment and at 48h after the injection of ³H-cholesterol labeled RAW264.7 macrophages increased significantly (P＜ 0.05). Conclusion MCT can reduce the body weight and body fat, and it also can improve cholesterol metabolism and promote RCT in mice with hypercholesterolemia.