To investigate the effect of interaction between paranoxonase 1 (PON1)gene polymorphism and ATP-binding cassette transporter 1 (ABCA1) genetic variation on serum lipid level.Polymerase chain reaction-restricted fragments length polymorphism was used to determine PON1 A/B192 and ABCA1R219K genotype of 1019 subjects, including 680 patients with strokes and 339 healthy individuals as controls.No significant association between A/B192 genotype and any of the lipid measurements was detected. The levels of HDL-C in the subjects with RR, RK and KK genotypes showed a significant upward tendency respectively (P < 0.05); the levels of their triglyceride (TG) tended downward respectively, but there were no significant differences between them. The relationship between R219K genotype and serum lipid level was modified by A/B192 genotype. The levels of HDL-C in the subjects with AA/RR genotype and BB/KK genotype [(1.41 +/- 0.40) mmol/L, (1.41 +/- 0.39) mmol/L] were significantly different from that in the subjects with BB/RR genotype [(1.28 +/- 0.36) mmol/L] (P < 0.05).The result exhibited an interaction of PON1 A/B192 and ABCA1 R219K on serum lipid level.