Degenerative valvular aortic stenosis (AS) and atherosclerosis share similar risk factors, including hyperlipidemia. The study aim was to determine whether patients undergoing aortic valve replacement (AVR) for AS, with or without concomitant coronary artery bypass grafting (CABG), had more abnormal lipid profiles than those undergoing AVR for regurgitant lesions. The lipid profiles of four groups of surgical patients were compared: AVR for aortic regurgitation (n = 370); AVR for predominant AS (n = 1,072); AVR for AS with concomitant CABG (n = 914); isolated CABG (n = 11,156). Total cholesterol levels, triglycerides and low-density lipoproteins (LDL-C) were modestly, yet significantly, increased in each successive group, while high-density lipoproteins were decreased. AS patients undergoing isolated AVR had significantly higher total cholesterol (215 versus 201 mg/dl; p <0.0001), triglycerides (125 versus 104 mg/dl; p <0.0001) and LDL-C (139 versus 132 mg/dl; p = 0.003) than those undergoing AVR for aortic regurgitation. It is concluded that progressively abnormal lipid profiles are associated with AS and coronary disease in patients undergoing AVR, lending further support to the association between dyslipidemia and valvular AS.