Diet-induced atherosclerosis developed more extensively in vasectomized cynomolgus monkeys (Macaca fascicularis) than in sham-vasectomized control monkeys fed the same diet. The effect was most pronounced in the abdominal aortas, carotid arteries, distal segments of the coronary arteries, and intracranial cerebral arteries. Antibodies to sperm developed in all vasectomized monkeys, and complement and immunoglobulins were associated with atherosclerotic plaques in some of the vasectomized animals. The immunological response to sperm antigens that often accompanies vasectomy may exacerbate atherosclerosis.