We studied 4,543 male physicians to assess accuracy of self-reported cholesterol level. The rate of accurate reporting improved over 14 years (25% to 62%), while failing to report a cholesterol level decreased. Overweight, current or past smoking, and physical inactivity were significantly associated with not reporting or inaccurately reporting cholesterol level. Though an increasing proportion of physicians accurately reported their cholesterol level over time, those at increased risk for developing cardiovascular disease tended to underestimate or fail to report their cholesterol level. Knowledge may be a critical factor in empowering physicians and patients to advocate for and adopt healthier lifestyles. EDITORS' STRATEGIC IMPLICATIONS: Rates of sedentary behavior and obesity in the U.S. continue to rise. In this promising study with a large sample, a longitudinal design, and multi-method assessments, we find that--even among this sample of highly educated medical professionals--those individuals who are at greatest cardiovascular risk might require different types of monitoring, motivational interventions, or health education.