Abstract: Objective To investigate the serum lipid levels in rural residents with diabetes and pre-diabetes conditions in Chengdu. Methods Random cluster sampling method was employed to select participants of 35-70 year-old rural residents in Chengdu. The participants (n=971) were given standard 75 g oral glucose tolerance tests (OGTT) and divided into five groups: impaired fasting glucose (IFG) group, impaired glucose tolerance (IGT) group, IFG and IGT(IFG+IGT) group, diabetes mellitus (DM) group and normal glucose tolerance (NGT) group. Their serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c) were measured. Results The age-adjusted standardized prevalence of DM and pre-diabetes in rural residents in Chengdu were 12.8% and 34.5%, respectively, without significant gender differences. IGT was the most common type of abnormal glucose metabolism in pre-diabetes. High serum TG and LDL-c and low serum HDL-c were found in 45.9%, 30.6% and 9.9% participants with DM, respectively. High serum LDL-c and TG and low serum HDL-c were found in 38.1%, 30.6% and 7.6% of participants with IGR. Participants with DM or/and IGR had higher levels of LDL-c and TG and lower levels of HDL-c than those in the NGT group. Conclusion Pre-diabetes and diabetes are prevalent in rural residents in Chengdu, which are usually accompanied with various degrees of dyslipidemia.