Introduction: We examined the extent to which the Danish College of General Practitioners' guidelines of 1998, "Prevention of ischaemic heart disease in general practice - with special focus on dyslipidaemia", are complied with in the secondary preventive care of patients with ischaemic heart disease. Material and Method: Twenty-six general practitioners from Ringkjøbing Country registered all patients with ischaemic heart disease consecutively over three weeks in May 1999. One hundred and ten patients had suffered acute myocardial infarction, 141 had ischaemic heart disease without acute myocardial infarction. Blood pressure, total cholesterol, and use of cardiovascular drugs were registered. Results: In patients with previous acute myocardial infarction, 66% had had their serum cholesterol measured within the past year, 76% were being treated with acetylsalicylic acid, 46% with beta-blockers, and 27% with lipid-lowering drugs. Of the patients with previous myocardial infarction and a serum cholesterol level ≥5.0 mmol/l, 33% took lipid-lowering drugs. Discussion: The present study demonstrates that in some areas actual treatment practice does not always comply with the given recommendations. In particular the frequency of cholesterol measuring and treatment with beta-blockers and lipid-lowering drugs show that continued, targeted quality development is required.