OBJECTIVES: Dyslipidemia is a common chronic disease in China, which is a main risk factor for cardiovascular and cerebrovascular diseases. Blood lipid screening is a positive method for prevention of dyslipidemia, but the cost-effectiveness of blood lipid screening is still unknown. The objective of this study aims to evaluate the cost-effectiveness of blood lipid screening versus no screening for the primary prevention of hyperlipidemia and its complication. METHODS: A Markov model was designed according to dyslipidemia clinical development and pathway for the cost-effectiveness analysis. Markov model simulated the long term effects of screening and no screening strategies. The model assumed the starting age of 45 and a 30 year horizon. All the data for Markov model were extracted from literatures published. The costs and benefits were both discounted at 5%. Sensitivity analyses were adopted to explore assumptions of the model and to identify which model inputs had most impact on the results.  RESULTS: The model results showed that the per capita cumulative costs and utilities in no screening group were CNY65343 and 12.58 QALYs, and CNY 64337 and 12.9 QALYs in screening group. Comparing with the no screening group, the screening had lower costs and higher utility. The results of One-way sensitivity analysis showed that the transition probability from dyslipidemia (no screening) to complications, the transition probability from dyslipidemia (screening detected) to complications and the cost of drug intervention had obvious impacts on the model results.  CONCLUSIONS: Based on this Markov model, blood lipid screening is likely to be cost-effective compared with no screening for the primary prevention of dyslipidemia and its complication among Chinese aged 45 and above.