OBJECTIVE To estimate the prevalence of dyslipidemia (DLP) among individuals with idiopathic granuloma annulare and to examine associations with disease characteristics and comorbidities, such as metabolic syndrome. METHODS Case-control study using review of medical records from January 2002 through December 2010. METHODS A university hospital and a health care system. METHODS Adults consisting of 140 patients and 420 individuals serving as controls matched for age, sex, race/ethnicity, hypertension, type 2 diabetes mellitus, and hypothyroidism. METHODS Prevalence of DLP and its associated components (hypercholesterolemia, hypertriglyceridemia, elevated low-density lipoprotein cholesterol, and low high-density lipoprotein cholesterol) in idiopathic granuloma annulare, as well as odds ratio of DLP after adjusting for confounding variables. RESULTS The prevalence of DLP was 79.3% among granuloma annulare cases and 51.9% among controls (P.001). Granuloma annulare was associated with DLP (odds ratio, 4.04;95%CI,2.53-6.46) after adjusting for confounding variables. Statistically significant differences between patient and control groups were found for levels of total cholesterol, triglycerides, and low-density lipoprotein cholesterol (P.001 for all variables). A statistically significant association between the extent of disease and DLP (P=.02) was shown. Annular lesion morphology was associated with hypercholesterolemia (P=.02) and DLP (P=.01). CONCLUSIONS This study indicates an association between granuloma annulare and DLP. Dyslipidemia is more common in generalized than in localized/disseminated disease, and the annular lesion morphology is associated with hypercholesterolemia and DLP. Physicians should be aware of these important associations and consider them in the management of granuloma annulare.