To investigate the blood lipid levels and prevalence of dyslipidemia in people with hypertension and diabetes in Henan province. From April 2016 to April 2017, multi-stage cluster sampling was adopted to investigate 71 285 local residents aged between 35 and 75 from 6 districts and counties in Henan province including Zhongmu county of Zhengzhou city, Huojia county of Xinxiang city, Hualong district of Puyang city, Qi county of Hebi city, Xigong district of Luoyang city, and Wugang city of Pingdingshan city. Blood samples were collected. According to the diagnostic criteria of hypertension and diabetes, the study population was divided into control group (29 427), hypertension group (21 965), diabetes group (8 009) and hypertension-diabetes group (11 884). Comparisons on blood lipid levels and dyslipidemia between 4 groups were performed. The total cholesterol (TC) level of all subjects was 4.37 (3.78, 5.05) mmol/L. The triglyceride (TG) level was 1.27 (0.97, 1.80) mmol/L, the low-density lipoprotein cholesterol (LDL-C) level was 2.34 (1.88, 2.88) mmol/L and the high-density lipoprotein cholesterol (HDL-C) level was 1.31 (1.08, 1.59) mmol/L. Except for the TC level in women aged 65-75 years and LDL-C levels in women aged 55-64 and 65-75 years, there were significant differences in TC, TG, LDL-C and HDL-C levels between subjects of control group, hypertension group, diabetes group, and hypertension-diabetes group in different age ranges (including 35-44, 45-54, 55-64,and 65-75 years) and genders(all 0.01).Except for the LDL-C and HDL-C in men aged 35-44 years and LDL-C in women aged 65-75 years, there were significant differences in the dyslipidemia rates of TC, TG, LDL-C and HDL-C between subjects of control group, hypertension group, diabetes group and hypertension-diabetes group in different age ranges and genders(0.01 o0.05). After adjusting for age, gender, smoking, drinking, snoring, region, and body mass index, multivariate logistic regression analysis showed that hypertension (1.221, 95 1.113-1.339, 0.01), diabetes (1.636, 95 1.461-1.833, 0.01) and hypertension-diabetes (1.832, 95 1.658-2.023, 0.01) were independent risk factors for TC abnormality. Hypertension (1.566, 95 1.478-1.659, 0.01), diabetes (2.182, 95 2.031-2.342, 0.01) and hypertension-diabetes (2.655, 95 2.492-2.829, 0.01) were also independent risk factors for TG abnormality. Diabetes (1.510, 95 1.309-1.742, 0.01) and hypertension-diabetes (1.461, 95 1.285-1.661, 0.01) were independent risk factors for LDL-C abnormality. Diabetes (1.261, 95 1.180-1.346, 0.01) and hypertension-diabetes (1.195, 95 1.126-1.268, 0.01) were independent risk factors for HDL-C abnormality. The prevalence of dyslipidemia in patients with hypertension and diabetes is high in Henan province, so adequate blood lipid education and control should be applied to people with risk factors as soon as possible.