Aim To investigate the relationship between homocysteine levels and dyslipidemia in patients with hyperhomocysteinemia. Methods A retrospective study was conducted on the data of 58 297 physical examiners who were admitted to a medical examination institution in a city in northern China from February 2017 to December 2017. The chi-square test was used to analyze the difference of homocysteine levels in physical examiners, and logistic regression analysis was performed to control the effects of age, gender and body mass index (BMI) on the outcome. Results Logistic regression analysis showed that male (OR=3.1,5%CI:3.265～4.564) and impaired fasting glucose (OR=1.2,5%CI:1.034～1.639) were risk factors for hyperhomocysteine. And with the increase of apolipoprotein AⅠ, the risk of hyperhomocysteinemia decreased (OR=0.2,5%CI:0.515～0.904). Conclusions Homocysteine levels may be associated with hyperlipidemia, especially for hypertriglyceridemia. And the risk of hyperhomocysteinemia decreases with the increase of apolipoprotein AⅠ.