Abstract: Objective: To investigate the levels of plasma lipids in patients with bile-tract cancer and cholelithiasis and to study the relationship between them. Methods: A population-based case-control study was conducted in urban Shanghai. Six indices of serum lipids were assayed in 462 newcases of biliary tract cancers, 982 patients with cholelithiasis and 808 healthy subjects. Non-parametric statistical method (Kruskal-Wallis rank sum test) was used to analyze and compare the level of serum lipids among patients with biliary tract cancer, gallstones and the normal controls. Results: Among male patients with gallstones, the concentration of triglycerides (TG) in biliary tract cancer patients was higher than that in cholelithiasis patients and the normal controls. The levels of HDL were statistically different among biliary tract cancer, cholelithiasis patients and the normal controls. Moreover, the levels of HDL were lower among the cases of all three sites of biliary tract cancers and gallstone disease patients than those in the normal controls. Among male subjects without gallstones, the concentrations of TG and ApoB in the group with biliary tract cancers were higher compared to those in the control group, while the concentrations of TC, HDL, LDL and ApoA were lower than those in the controls. Among female subjects with cholelithiasis, the levels of HDL and ApoA were statistically different among patients of biliary tract cancers, gallstone disease patients and normal controls. For female subjects without gallstones,the mean concentrations of HDL and ApoA among biliary tract cancers patients were significantly lower than those innormal controls.Conclusion: Forbothgenders,lipoprotein metabolism abnormalities with hypertriglyceridemia and lowserum levels of HDL were observed among biliary tract cancers.