OBJECTIVE To investigate the effect of warm-reinforcing needling (WRN) on serum lipid metabolism in hyperlipoidemia (HL) rabbits. METHODS A total of 32 rabbits were randomly and evenly divided into control group, WRN group, model group and uniform reinforcing-reducing needling (URRN) group. HL model was established by feeding the rabbits with hypercholesterol and high-fat forage continuously for 7 weeks. For rabbits of WRN and URRN groups, "Zusanli" (ST 36), "Sanyinjiao" (SP 6), "Xuehai" (SP 10) were punctured and stimulated manually with WRN and URRN techniques respectively, once daily, continuously for 7 weeks. At the end of experiments, blood samples were collected from the heart, and centrifuged for detecting serum total cholesterol (TC) triglyceride (TG) and high density lipoprotein (HDL) with enzyme method, and platelet aggregation rate (PAR) with an intelligent blood agglutometer. Low density lipoprotein (LDL) = TC- (HDL + TG/2.2). RESULTS Compared with normal control group, serum TC, TG and LDL contents in model group, WRN and URRN groups increased significantly (P < 0.01), and HDL content of model group decreased considerably (P < 0.01); while in comparison with model group, serum TC, LDL and TG contents of WRN and URRN groups decreased considerably (P < 0.01), and serum HDL levels of WRN and URRN groups increased significantly (P < 0.01). Serum TC content of WRN group was markedly lower than that of URRN group (P < 0.05), and HDL of WRN group was remarkably higher than that of URRN group (P < 0.01). In comparison with normal control group, 1 min, 5 min and maximum PARs in model, WRN and URRN groups increased significantly (P < 0.01), while in comparison with model group, 1 min, 5 min and maximum PARs of WRN and URRN groups decreased considerably (P < 0.01). In addition, 1 min and maximum PARs in WRN group were markedly lower than those in URRN group (P < 0.05). Light microscopic observation showed that the apoptotic foam cells in the lipid plaque of aorta wall in model group appeared and were obviously more than those of WRN and URRN groups. CONCLUSION Acupuncture can effectively lower serum TC, LDL and TG levels, raise serum HDL content, and suppress platelet aggregation, and the therapeutic effect of WRN is significantly superior to that of URRN, which may contribute to the action of acupuncture in regulating blood lipid and inhibiting the formation of atheromatous plaque.