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The pathological complications of atherosclerosis, namely heart attacks and strokes, remain the leading cause of mortality in the Western world1). Preceding atherosclerosis is endothelial dysfunction2-4). The endothelium comprises a continuous monolayer of cells which separate the vascular wall from the circulation5). Disruption of this essential monolayer is thought to occur early in the pathogenesis of cardiovascular disease (CVD). There is therefore interest in the application of non-invasive clinical tools to assess the function and health of this essential monolayer. The flow-mediated dilation (FMD) test is the standard tool used to assess endothelial function6, 7). Reduced FMD is an early marker of atherosclerosis6), has been noted for its capacity to predict future CVD events8-11), and an impaired vascular response has also been demonstrated in children as young as 7 years old with familial hypercholesterolemia12). This review discusses the measurement of endothelial function, with a focus on the FMD technique.