Low-density lipoprotein (LDL) concentrations correlate with risk of coronary heart disease, and genetic variation affecting LDL levels influences atherosclerosis susceptibility. The principal LDL protein is apolipoprotein B (apoB); apoB is not exchangeable between lipoprotein particles and there is only one apoB per LDL particle. Plasma LDL therefore consists of two populations, one containing apoB derived from the maternal and one from the paternal apoB alleles. Products of the apob gene with high or low affinity for the MB-19 monoclonal antibody can be distinguished, and this antibody was used to identify heterozygotes with allele-specific differences in the amount ofapoB in their plasma. A family study confirmed that the unequal expression phenotype was inherited in an autosomal dominant manner and was linked to the apob gene locus. Significant apoB genetic variation affecting plasma LDL levels may be more common than previously appreciated.