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Abstract Background Little is known about serum lipid levels comparison of patients with acute myocardial infarction (AMI) in Hakka patients in southern China. To estimate the prevalence lipid profiles in Hakka patients with AMI in southern China. Method We analyzed 1382 patients with a first AMI in Hakka patients in southern China between Jan. 2015 and Dec. 2015. Results Our findings demonstrated that low-density lipoprotein cholesterol (LDL), total cholesterol (TC), and triglyceride (TG) were higher in nonelderly than in elderly for males. There were significant differences in TC, LDL, HDL, and TG among various age groups for both males and female patients (P < .05). TC, LDL, HDL, and TG were higher in females than males for the elderly, and the LDL levels of females were higher in 70–79,80–89 year age groups than males. The HDL level of female patients was higher than males in those 50–59, 60–69, and 70–79 year age groups. Compared with males, females had higher level of TG in the 60–69, 70–79, and 80–89 year age groups and had higher level of TC in the 50–59, 70–79, and 80–89 year age groups, respectively. Isolated high TG (normal LDL + normal HDL+ high TG) was most common type of combined dyslipidemia for female elderly (22.2%), female nonelderly (23.2%) and male elderly (24.1%) patients. Conclusion Our results confirmed that serum lipid levels varied in age and gender in Hakka patients with acute myocardial infarction. Dyslipidemia is more prevalent in the non-elderly than in the elderly for males. Levels of TC, LDL, HDL, and TG were higher in females than males for the elderly Hakka population in southern China.