The effect of the serum lipid levels on vertebral fractures and bone mineral density is not clear. A total of 107 postmenopausal women aged 45-79 examined by lumbar spine, hip and radius bone mineral density (BMD) measurements, lateral dorsal and lumbar spine radiographies, routine blood tests and serum lipids [total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, VLDL-C]. Demographic and lifestyle characteristics were collected. Eighty-nine radiographies with good technical properties were scored by the Kleerekoper method. Patients with vertebrae fractures had lower levels of TC, TG, LDL-C than the patients without vertebrae fractures. Total cholesterol level was the most prominent factor affecting the vertebral fracture existence. An increase of 1 mg/dl total cholesterol decreases the risk of vertebrae fracture by 2.2%. The existence of osteoporosis due to T score was not influencing the lipid values. TC and LDL-C were weakly associated with BMD at the forearm UD region after the adjustment for the possible confounders. This study shows that the serum lipids have impact on vertebrae fracture existence rather than BMD alterations.