Aim To investigate the characteristics of blood lipid disorder in patients with rheumatoid arthritis (RA) and its correlation with disease activity. Methods 62 patients with RA were as the RA group, and 46 cases with age- and sex- matched healthy physical examination were as the control group. According to disease activity, RA group was divided into two subunits:active RA group and inactive RA group. General parameters and the traditional risk factors of cardiovascular disease were recorded; Body mass index (BMI) was calculated; Systolic blood pressure and diastolic blood pressure were measured; Serum triglyceride, total cholesterol (TC), low density lipoprotein cholesterol, high density lipoprotein cholesterol (HDLC), high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate (ESR) were detected. Differences of blood lipids, hs-CRP and ESR were compared among each group. Correlations between blood lipids and hs-CRP, ESR in RA patients were analyzed by Pearson linear correlation analysis. Results BMI of RA group was significantly higher than that of control group (P<0.05). Serum TC levels in active RA group and inactive RA group were significantly higher than that in control group (P<0.05). Serum HDLC level in active RA group was significantly lower than those in inactive RA group and control group (P<0.01), and serum HDLC level in inactive RA group was significantly lower than that in control group (P<0.01). TC/HDLC ratio in active RA group was significantly higher than those in inactive RA group and control group (P<0.01), and TC/HDLC ratio in inactive RA group was significantly higher than that in control group (P<0.05). In RA patients, serum HDLC level was negatively correlated with hs-CRP and ESR (r＝－0.532, P＝0.000; r＝－0.508, P＝0.000), and TC/HDLC was positively correlated with hs-CRP and ESR (r＝0.321, P＝0.001; r＝0.246, P＝0.030). Conclusions Blood lipids metabolic disorder in RA patient is mainly the decrease of HDLC. Serum HDLC level is significantly decreased in active RA patient, which is closely related with RA disease activity.