A novel analytical platform based on liquid chromatography and tandem mass spectrometry using atmospheric pressure photoionization was applied for the simultaneous quantification of free and esterified  -sitosterol, campesterol, brassicasterol, and stigmasterol. The total time for sample pretreatment and analysis could be reduced from ف 3 h [gas chromatography-mass spectrometry (GC-MS)] to 15 min. The detection limits of the different phytosterols ranged between 0.25 and 0.68 g/l. Linear ranges were between 1 and 1,000 g/l. The within-run and between-run variabilities ranged between 1.4% and 9.9%. The analytical sensitivity was at least 150-fold higher compared with GC-MS. Our new method allows a rapid and simultaneous determination of free and esterified phytosterols in serum. Phytosterols are common components of plant foods, especially vegetable oils, seeds, nuts, and cereals (1). They are structurally similar to cholesterol, differing only in the number of carbons or double bonds in the side chain. An average Western diet contains ف 200-400 mg of phytosterols per day (e.g.,  -sitosterol, campesterol, stigmasterol, and brassicasterol). All serum and tissue phytosterols are derived exclusively by intestinal absorption. Therefore, serum levels of phytosterols reflect dietary plant sterol intake and intestinal absorption (2). The individual differences in plasma phytosterol concentrations are highly heritable (3). Compared with dietary cholesterol, the intestinal absorption rate of dietary phytosterols is markedly lower, because the bulk of absorbed phytosterols is immediately secreted into the intestine by the ATP-binding cassette half-transporters ABCG5 and ABCG8 of the enterocytes (4). Mutations in either of the transporter genes have been identified as the cause of sitosterolemia, a rare autosomal recessive lipid disorder that is characterized by markedly increased serum phytosterol concentrations (e.g.,  -sitosterol Ͼ 50 mg/l) as a consequence of hyperabsorption and impaired biliary secretion of neutral sterols (5-7). These patients develop premature coronary heart disease (8, 9). A recent study in patients admitted for elective coronary artery bypass graft surgery supports the hypothesis that even slightly increased campesterol (3.8 Ϯ 1.6 mg/l) and  -sitosterol (3.1 Ϯ 1.1 mg/l) concentrations in serum may contribute to the risk of coronary heart disease (10).Sensitive analytical methods are necessary to detect physiological phytosterol concentrations and even slightly increased concentrations in human serum. Currently available methods for the measurement of phytosterols in serum are based on GC-MS. However, this analytical platform is time-consuming and requires a laborious pretreatment procedure (hydrolysis, liquid-liquid extraction, and derivatization) and a large sample volume (11,12). Recently described liquid chromatography-mass spectrometry (LC-MS) methods for the determination of cholesterol and oxidized metabolites in human plasma also include time-consuming extraction and hydroly...