Introduction : Hyperlipidemia is closely related to the generation of coronary heart disease (CHD). The objective of this study was to compare the efficacy of acipimox and fenofibrate for the treatment of hyperlipidemia. Methods : The study performed a retrospective comparison of acipimox (250 mg TID) and fenofibrate (200 mg/day) by comparing the means of changes in total cholesterol, triglyceride, HDL-C, LDL-C levels, and TC/HDL-C ratio at 3, 6, and 9 months of the treatments. Results: A total of 103 patients (41 in acipimox group and 62 in fenofibrate group) were evaluated. Acipimox- and fenofibrate-treated group were comparable with respect to patient demographic characteristics. After treatments both acipimox and fenofibrate produced a significant reduction in total cholesterol(9.7% with acipimox; 11.3% with fenofibrate), triglyceride levels (52.6% with acipimox, p<0.001; 54.3% with fenofibrate, p<0.001) and TC/HDL-C ratio(15.2% with acipimox; 18.0% with fenofibrate) from baseline. HDL-C levels after treatments increased by 8.4% and 9.3% with acipimox and fenofibrate, respectively. Both drugs did not produce a significant reduction in LDL-C levels (4.4% with acipimox; 2.0% with fenofibrate) after treatments. The mean changes of total cholesterol, triglyceride, LDL-C, HDL-C levels and TC/HDL -C ratio were not significantly different between the two drugs. Conclusion : Both acipimox- and fenofibrate- treated groups experienced significant changes in total cholesterol, triglyceride, HDL-C, and TC/HDL -C ratio from the baseline 따ter treatments.