Aim To analyze the correlation factors of achilles tendon thickness in patients with hypercholesterolemia, and offer comprehensive prevention and treatments for patients with hypercholesterolemia accompanied by achilles tendon thickening. Methods 104 patients (50 males and 54 females) with hypercholesterolemia, aged between 18 and 70 years old, were enrolled into this study from March 2014 to March 2015. They were divided into achilles tendon thickening group of 41 cases and achilles tendon normal group of 64 cases, comparing the differences of general clinical data between the two groups, and single and multiple regression analysis were made to assess the correlation factors of achilles tendon thickness in hypercholesterolemia patients. Results There existed significant difference in body weight (63.70±11.16 kg vs. 56.45±9.96 kg), height (162.91±6.48 cm vs. 160.08±6.90 cm), body mass index (24.03±3.30 kg/m² vs. 22.17±2.83 kg/m²), the level of TC (8.47±1.39 mmol/L vs. 7.67±1.94 mmol/L), the level of LDLC (6.14±0.99 mmol/L vs. 5.12±0.13 mmol/L), the level of HDLC (1.17±0.42 mmol/L vs. 1.97±1.31 mmol/L) and the level of apolipoprotein AI (1.18±0.26 mmol/L vs. 1.62±0.21 mmol/L) between the achilles tendon thickening group and the achilles tendon normal group in patients with hypercholesterolemia. Univariate Logistic regression analysis showed that the achilles tendon thickness had significant difference in different height (OR＝1.4,5%CI was 1.002~1.129), body mass index (OR＝1.1,5%CI was 1.064~1.390), TC (OR＝1.1,5%CI was 1.014~1.715), HDLC(OR＝0.8,5%CI was 0.007~0.115), LDLC (OR＝2.5,5%CI was 1.494~3.807), ApoAI(OR＝0.6,5%CI was 0.001~0.046) in hypercholesterolemia patients. Multiple Logistic regression analysis showed that LDLC (OR＝1.1,5%CI was 1.067~3.280) was risk factor while HDLC(OR＝0.9,5%CI was 0.017~0.573) and apolipoprotein AI (OR＝0.5,5%CI was 0.003~0.412) were protective factors of achilles tendon thickness in hypercholesterolemia patients. Conclusion The hypercholesterolemia patients with thickened achilles tendon thickness have higher serum cholesterol levels. Serum LDLC is the independent risk factor while HDLC and apolipoprotein AI are protective factors in patients with hypercholesterolemia. So it is imperative to take intensive treatment in hypercholesterolemia patients accompanied with thickened achilles tendon thickness.