BACKGROUND: Multiple guidelines recommend detection of and early risk factor management for elevated lipoprotein(a) [Lp(a)]. Effective implementation requires assessment of knowledge and practices regarding elevated Lp(a) among medical specialists. AIM: To assess awareness, knowledge and practices of the detection and treatment of elevated Lp(a) among specialist physicians in Singapore. METHODS: Seventy-five practicing specialists in cardiology ( = 33) or endocrinology ( = 42) anonymously completed a structured questionnaire that assessed the above three aims. RESULTS: The majority of respondents (83%) rated their familiarity with Lp(a) as at least average, with a greater percentage of endocrinologists being less familiar with Lp(a) than cardiologists (29% vs. 3%,  < 0.01). 57% were aware of at least one guideline or consensus statement on Lp(a), which was more frequent among cardiologists than endocrinologists (70% vs. 48%,  = 0.05). There were major gaps in knowledge of the prevalence, pathophysiological role, clinical significance and management of elevated Lp(a), correct responses being less than 30%; 44% of respondents (33% cardiologists and 52% endocrinologists) never tested for Lp(a), lack of effective treatment being the most common barrier (59%). A higher proportion of specialists that did not test for Lp(a) rated familiarity with Lp(a) as being low compared with specialists that tested for Lp(a) regularly (33% vs. 13%,  = 0.02). Education and training were considered most useful for improving care of patients with elevated Lp(a). CONCLUSION: Major gaps in awareness, knowledge and management of elevated Lp(a) were identified among specialists in Singapore. Education and training of specialists are required to overcome initial barriers to testing.