Background: It has been debated that serum lipid levels of patients with xanthelasma are higher than those of normal persons. In Korean literature, there are two reports of this. Objective: Our purpose was to review the findings in patients with xanthelasma and compare the patients to normal persons in respect of serum lipid levels. Methods: Fifty-one patients with xanthelasma were reviewed. Results: Mean age was 51 years in man and 51 years in woman. The ratio of male to female patients was 1:2.7. Significant difference of serum HDL-cholesterol level was found between patients with normal lipid level and normolipidemic control subjects. Conclusion: Xanthelasma palpebrarum occurs frequently in middle-aged women and HDL-cholesterol level of patients with xanthelasma was lower than normolipidemic control subjects.