The purpose of this study was to provide data on lipid distribution and to investigate the association between hypercholesterolemia and other factors. A cross-sectional survey of insured subjects in an Health Center of Guadeloupe in 1999. Data from a consecutive series of 1 010 individuals aged 18 years and older, collected during a 3 month-period, were used. Standardized interviews and measurements of blood lipid abnormalities and other cardiovascular risk factors were carried out. Overall, 27% had elevated total cholesterol (TC) levels above 200 mg/dL, 11.7% had TC levels above 240 mg/dL, 18.1% had LDL-C levels above160 mg/dL, 12.5% had HDL-C below 35 mg/dL and 2.7% had triglyceride levels above 200 mg/dL. Isolated low HDL-C was found in 22% of the subjects and 10.8% had both TC above 240 mg/dL and LDL-C above 160 mg/dL. Only 22% of the subjects with high TC were aware of their diagnosis and 5% were treated. The risk of having hypercholesterolemia above 200 mg/dL was independently and significantly higher in case of hypertension, age above 45 in men or 55 in women, body mass index above 30 and familial history of dyslipidemia. These findings document the first report on dyslipidemia in Guadeloupe. It showed that the prevalence of hypercholesterolemia and hypertriglyceridemia was lower than in developed countries, but markedly higher than in Africa. Modifications of lifestyle and adapted therapeutics are necessary to decrease cardiovascular mortality.