To assess current status of serum lipid levels in healthy inhabitants of China and their secular trend in the past 5 decades. Methods： The authors reviewed the contemporary literature (studies published between 1959 and 2002; bibliographies of reviews and original articles). Articles were included if they were following a standardized protocol for serum collection and lipid examination. Thirty-five articles in different target population from Beijin, Shanghai, Guangzhou, Tianjin and Kunming met inclusion criteria. This paper summarized important results of these studies and also the author´s own study performed in Shanghai on lipid epidemiology. Results： (1)The levels of blood total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) increased along with the age. The levels of TC, TG and LDL-C among women before fifty were similar to that of among men of the same age, but higher in women than men over fifty. The TC, TG and LDL-C levels were higher in urban area than in rural area. (2) The levels of high density lipoprotein cholesterol (HDL-C) kept stability with aging, and they were lower in men than in women. (3)Secular trend analyses showed that the level of TC, TG and LDL-C increased steadily and significantly in all population, which reached the highest level at the end of 1990s, while HDL-C level decreased. (4) The prevalence of hypercholesterolemia (TC＞ 200 - 220 mg/dL) differed greatly among different population, from 17.8% to 54.9% in men, and from 14.9% to 53.4% in women, respectively. (5) Possible determinants for these changes were alternations in the composition of the diet in Chinese population along with the rise of living standards of the people. Daily intake of dietary fat, animal protein and cholesterol increased, while the proportion of carbohydrate decreased. (6) Coronary heart disease has been become the most common heart disease in China correlating with these changes. Prevention strategies： Primary prevention including： (1) resume healthy diet and have reasonable composition of the diet; (2) have lifestyle modifications and reduce other coronary heart disease risk; (3) recommendation for increasing physical activity. Secondary prevention including： If the patient did not achieve recommended target lipid levels after 3 months of lifestyle modifications (dietary therapy and physical activity), he or she should receive pharmacotherapy for dislipidemia.