High density lipoprotein-cholesterol (HDLC) is regarded as an important protective factor against cardiovascular disease. There is an inverse relationship between its serum levels and risk of cardiovascular disease. However, in cardiovascular disease, diverse components of the high density lipoprotein(HDL) proteins,lipids or microRNAs suffer alterations, which propel a shift towards a dysfunctional state, where HDL becomes proatherogenic, prooxidant, and proinflammatory. This review is to summarize the structural and functional changes of the dysfunctional high density lipoprotein.