Objective　To understand the trends of serum lipid concentration and the prevalence of dyslipidemia in adults aged 35 years and older, and to compare the regional differences in lipids. Methods　Based on the data of Anhui Province in the Early Screening and Comprehensive Intervention Project for High-risk Groups of Cardiovascular Disease in China from 2017 to 2021, the change trend of blood lipid level and the prevalence rate of each region were plotted according to the year and different regions in the province, and the influencing factors of dyslipidemia were analyzed by multivariate regression model. Results　The overall average levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) demonstrated an increase followed by a slight decrease with age annually, while the levels of high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) fluctuated minimally. From 2017 to 2020, TC levels improved annually but increased again in 2021. Similar to TG and non-HDL-C, the average LDL-C level decreased annually from 2017 to 2019, while rebounded in 2020 and 2021 compared with the previous three years. In contrast, the HDL-C level continued to decline. With the exception of HDL-C, the overall blood lipid levels in the northern Anhui (n=31 716) were higher than those in the southern Anhui (n=50 681), and the lowest levels were found in the central Anhui (n=38 246). The prevalence of hypercholesterolemia (7.400%, 2 347/31 716), high LDL-C (5.228%, 1 658/31 716), low HDL-C (9.935%, 3 151/31 716), hypertriglyceridemia (18.212%, 5 776/31 716), and high non-HDL-C (5.789%, 1 836/31 716) were highest in the northern Anhui. Age, region, senior high school or above, smoking, drinking, systolic blood pressure, blood glucose, and body mass index were independent factors for dyslipidemia (P<0.05). Conclusion　The blood lipid level and prevalence of dyslipidemia in adults aged ≥35 years in Anhui Province have not yet reached an ideal control level, especially in the northern part of Anhui Province where there is a need for enhanced awareness and timely intervention measures for lipid-related diseases to effectively extend the life expectancy of residents.