OBJECTIVE: To explore the relationship between serum lipoproteins and clinical presentations of NMO patients. To investigate the differences of serum lipoprotein levels between NMO and MS patients. PATIENTS AND METHODS: Serum lipoprotein levels were measured in 56 NMO patients, 53 MS patients and 54 health subjects. Serum lipoprotein levels in all participants and relevant clinical parameters of NMO patients were investigated. Statistical analyses were performed using the SPSS statistical software. RESULTS: NMO patients had significantly higher serum cholesterol (TC), triglyceride, low-density lipoprotein cholesterol, apolipoprotein B (apoB), lipoprotein (a) levels and TC/HDL-C, apoB/apoA-1 ratios than health control group. NMO patients had significantly higher serum apoB level and apoB/apoA-1 ratio than MS patients. There was little correlation between serum lipoproteins and NMO presentations. CONCLUSION: The elevated lipoprotein levels in NMO patients could be just secondary changes with limited value in clinical prediction. However, elevated apoB level and apoB/apoA-1 ratio in NMO might indicate severer disability and might provide some useful information in the differential diagnosis with MS. Crown.