Aim To study the trend of changes in serum total cholesterol (TC) levels of governmental and institutional staffs of urban districts in Beijing during 1981-2001. Methods A total of 47 434 TC data were collected after annual physical examination, and analyzed statistically according to different sex, age and years. Serum TC measurements fulfilled the quality criteria of lipid standardization. Results ① TC level increased evidently in the period 1981 to 1988, and reached to the higher level at 1990, but was lower in 2001 than 1991. The age adjusted mean TC level during 1981～1990 increased by 0.73 mmol/L (28 mg/dL) in males, and 0.62 mmol/L (24 mg/dL) in females, but decreased by 0.21 and 0.23 mmol/L (8 and 9 mg/dL) respectively in males and females in the year 2001. ② TC increased with age in both sexes, however, the degree of increase was different in males and females. The elevation of TC level with age was more significant in young males than females, but was much more marked in females after middle age. From 40～49 to 50～59 age groups, the average TC increase was 3% in males, and 14% in females. It hardly increased after age 60 in both sexes. The total increase in TC from young age to elderly was 20% in males and 35% in females. Thus TC level in males was higher before age 50, but lower than in females after age 50. ③The prevalence rate of age standardized hypercholesteroleria [TC≥5.17mmol/L(200 mg/dL)、≥5.7 mmol/L(220 mg/dL)and ≥6.2 mmol/L(240 mg/dL)] was doubled approximately in 1991 compared with 1985, but somewhat lowered in 2001. ④The age adjusted mean TC is 4.86 mmol/L (188 mg/dL, male) and 4.78 mmol/L(185 mg/dL, female) with prevalence rate of age standardized high TC about 20% (≥5.7 mmol/L) or 10% (≥6.2 mmol/L) at present. Conclusion There was marked increase in prevalence rate of high TC in 1980′s, no more increase in 1990′s, but a little decrease in 2001.