Aim To investigate the association between plasma homocysteine (Hcy) and the C677T gene polymorphism of its key metabolic enzyme, methylenetetrahydrofolate reductase (MTHFR), and blood lipid abnormality among hypertensives of Chinese Han population. Methods A total of 312 adult essential hypertensive patients were selected as the study subjects. The average age of the selected patients was 58.25 years old, 178 cases were male, 134 cases were female. The personal information was collected, clinical biochemical indicators were tested, including plasma Hcy, serum lipid, fasting blood glucose (FBG), uric acid (UA) and so on. The C677T gene polymorphism of MTHFR was tested.According to guidelines for prevention and treatment of serum lipid in Chinese adults published in 7,4 cases were elected out as essential hypertension with blood lipid abnormality group and 118 cases as blood lipid normality group, and the blood lipid abnormality group was divided into 4 subgroups:54 cases of hypercholesterolemia group, 53 cases of hypertriglyceridemia group, 59 cases of mixed hyperlipidemia, and 22 cases of hypo high density lipoprotein cholesterolemia group, and subgroup analysis was performed. Results The body mass index (BMI), FBG, and UA of the blood lipid abnormality group were higher than those in the the blood lipid normality group (P＜0.01). There was no significant difference in the MTHFR C677T genotype frequency and allele frequency between blood lipid abnormality group and blood lipid normality group. Subgroup analysis showed that there was no significant difference in the MTHFR C677T genotype frequency and allele frequency among different subgroups, and also no significant difference between subgroups and blood lipid normality group. The level of different blood lipid was not significant among genotypes. The level of Hcy in TT genotype was higher than that in CT and CC genotype (P＜0.05), the level of Hcy was not significant between CT and CC genotype (P＞0.05). Plasma Hcy was negatively correlated with high density lipoprotein cholesterol (HDLC)(r＝－0.116, P＜0.05), but had no correlation with total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC) (P＞0.05). After adjusting for age, BMI, UA and FBG, the correlation between Hcy and LDLC disappeared. Logistic regression analysis showed that the correlation between MTHFR C677T gene polymorphisms and blood lipid abnormality was not significant. Conclusions MTHFR C677T polymorphisms was closely related to plasma Hcy, but had no correlation with blood lipid abnormality. The blood lipid abnormality was significantly associated with FBG, plasma UA and BMI, having no correlation with plasma Hcy, but plasma Hcy was negatively correlated with HDLC.