Red yeast rice (RYR) has been known to exhibit various biological effects, including anti-hyperlipidemia, antioxidant, anti-tumor, and anti-inflammtory activities. Oxidative stress is a main risk factor in the development of cardiovascular disease, such as atherosclerosis. Therefore, the aim of this study was to investigate the possible hypolipidemic and antioxidant effect of RYR on rats fed a high-cholesterol diet supplemented with either 0.2%, 1%, or 5% RYR for 4 weeks. We measured lipid profiles in the plasma and liver, antioxidant enzyme activities in plasma and erythrocyte, gene expression of antioxidant enzymes in the liver, and oxidative DNA damage in lymphocytes. The group supplemented with 0.2% RYR had total cholesterol level in plasma decreased by 24%, while the group supplemented with 5% RYR had high-density cholesterol increased by 20% compared to the control. The antioxidant enzyme activities were also affected by RYR supplementation. Total superoxide dismutase activities in plasma significantly decreased by 11% in the 1% RYR group, while these activities in the liver significantly decreased by 16% and 21% in the 1% and 5% supplemented group compared to the control, respectively. Glutathione peroxidase activities in plasma and erythrocytes increased 13% and 48% in the 1% RYR group, respectively. Catalase (CAT) activity in erythrocytes significantly increased by 49% and 68% in the 1% and 5% RYR group compared to the control, respectively. The gene expression of CAT was up-regulated 7.9 fold compared to the control in the 5% RYR supplemented group. These results suggest that RYR can control hyperlipidemia by improving the lipid profile and modulating oxidative stress.