Objective: To investigate the characteristics of blood lipid metabolism in patients with rheumatoid arthritis (RA) and its correlation with disease activity score in 28 joints (DAS28) and carotid intima-media thickness (CIMT). Methods: A total of 82 patients with RA from June 2016 to April 2020 were selected as RA group. Another 35 healthy volunteers were selected as the control group. Total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), and lipoprotein a (LPA) were detected. The disease activity of RA group was evaluated by DAS28 score, and CIMT was examined by ultrasound. The blood lipid level, DAS28 score and CIMT of RA group were analyzed. Results: TC, TG, LDL-C, LPA of RA group were higher than those of control group, HDL-C was lower, dyslipidemia rate was 68.29% higher than 22.86% of control group, and the difference was statistically significant (P<0.05); LPA in active RA group was higher than that in inactive RA group, HDL-C was lower, the difference was statistically significant (P<0.05); TC, TG, LDL-C, LPA levels in abnormal CIMT group were higher than those in normal CIMT group, HDL-C was lower, the difference was statistically significant (P<0.05). HDL-C was negatively correlated with DAS28 score, LPA was positively correlated with DAS28 score (r=−0.335, 0.382, P<0.05), TC, TG, LDL-C, LPA levels were positively correlated with CIMT, and HDL-C was negatively correlated with CIMT (r=0.421, 0.435, 0.418, 0.429, −0.437, P<0.05). Conclusion: Lipid metabolism disorder is common in RA patients, and blood lipid level is closely related to DAS28 score and CIMT. Attention should be paid to the monitoring and management of blood lipids in RA patients.