Objectives : To investigate the fetal cholesterol levels and related factors in a rural adult population. Methods : 3,207 adults(1,272 men and 1,935 women) were examined in 1997 Their heights, weights, and fasting serum total cholesterol levels were measured, and their body mass indices were calculated. A questionnaire interviewing method was used to collect risk factor data. Results : The mean value of total cholesterol were 190.5 mg/dl, and 198.8 mg/dl, and the age-adjusted prevalence rates for hypercholesterolemia (above 240 mg/dl) were 13.7% and 10.2%, in men and women, respectively. From simple analyses, age, educational level, coffee intake, amount of meat and food intake, waist circumference, waist-hip circumference ratio(WHR), and body mass index(BMI) were significant risk factors in men (p<0.05) relating to serum total cholesterol levels. In women, age, educational level, hypertension history, diabetes history, herbal drug history, amount of feed intake, alcohol consumption, waist circumference, WHR, BMI, and menopausal status were significant risk factors (p<0.05). In multiple linear regression analyses, waist circumference (p<0.01), BMI (p<0.01), and coffee intake (p<0.05) proved to be significant risk factors in men. Whereas, menopausal status (p<0.01), BMI (p<0.01), herbal drug history (p<0.01), amount of food intake (p<0.05), waist circumference (p<0.05), and alcohol consumption (p<0.05) were significant risk factors in women. Conclusions : The significant risk factors, for both men and women, relating to the serum total cholesterol were waist circumference and BMI. Thus, for the reduction of serum total cholesterol level, it is recommended that health education for the control of obesity should be implemented.