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 RCT is a multiorgan pathway that facilitates the removal of excess cholesterol from the body and this homeostatic pathway is conserved across a wide range of organisms , , , ,  and . Importantly, elevated flux through the RCT pathway is thought to protect against CVD primarily by facilitating cholesterol removal from within the atherosclerotic plaque ,  and . The vast majority of the literature assumes that RCT involves the sequential movement of macrophage-derived cholesterol from peripheral tissues to the liver for excretion into bile and subsequent loss through the feces ,  and . In this well-accepted model, biliary secretion of cholesterol is a requisite for the final step of RCT; namely, fecal cholesterol and bile acid excretion ,  and . Relevant to this review, emerging evidence supports an unexpected role for the small intestine in actively secreting plasma-derived cholesterol through a process that does not rely on hepatobiliary cholesterol secretion , , , , , , , ,  and . The identification of this non-biliary pathway largely stems from multiple observations where biliary cholesterol secretion does not predict the amount of cholesterol in the feces , , , , ,  and . Given that several recent reviews have been written surrounding the mounting evidence for the non-biliary TICE pathway , , , , ,  and , we refer the reader to these excellent resources for a historical perspective. (Full text )