The effect of water extract of adzuki beans on acetaminophen-altered lipid metabolism was examined in rats. Control group of rats was fed a basal diet, another group of rats was fed 0.5% acetaminophen (APAP group), and a third group of rats was fed 0.5% acetaminophen plus 5% adzuki bean extract (ABE group) for 4 weeks. Serum total and HDL cholesterol levels in the APAP group were significantly lower than those in the control and ABE groups. Hepatic cholesterol $7{alpha}-hydroxylase$ and fatty acid synthase mRNA levels in the APAP and ABE groups were significantly higher and lower than in the control group, respectively. Hepatic 3-hydroxy-3-methylglutaryl-coenzyme A reductase mRNA level in the APAP group was significantly lower than in the control group, whereas that in the ABE group was significantly higher than in the APAP group. These results indicate that adzuki bean extract may improve the acetaminophen-altered serum lipid metabolism in rats.