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Perfluoroalkyl acids (PFAAs) have been used in a variety of products for many years and have been detected worldwide in human serum. Previous studies have suggested the potential effects of PFAAs on serum lipids. To investigate the associations between serum concentrations of PFAAs and serum lipid levels, 133 participants were randomly selected from the people coming for health check-up in Yuanyang Red Cross Hospital of Henan, China. Linear regression analysis revealed that perfluoro-octanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA), with a median concentration of 1.43, 0.37, and 0.19 ng/mL, respectively, were positively associated with total cholesterol (TC). Those in the highest quartile of PFOA exposure had ln-TC levels 0.24 mmol/L higher than those in the lowest quartile. For PFNA and PFDA, effect estimates were 0.25 and 0.16 mmol/L, respectively. A positive association between high-density lipoprotein cholesterol (HDLC) and PFDA was found, and there was a 0.18 mmol/L increase of HDLC for the top PFDA quartile compared with the lowest quartile. PFOA and PFNA were positively associated with low-density lipoprotein cholesterol (LDLC). Ln-LDLC levels of people in both top PFOA and PFNA quartiles were 0.33 mmol/L higher than those in the lowest quartiles. Logistic regression analysis indicated that increased PFOA and PFOS quartiles were positively associated with an increased risk of abnormal TC and LDLC when controlling for no confounding factors., (Copyright © 2014 Elsevier Inc. All rights reserved.)