High serum total cholesterol is a type of hypercholesterolemia that can be seen in a variety of diseases such as familial hypercholesterolemia, hypothyroidism, and Cushing’s syndrome. Possible diseases with high serum total cholesterol are primary diseases such as familial hypercholesterolemia and familial hyper ApoB deficiency, or they may be manifestations of Cushing’s syndrome, hypothyroidism, systemic lupus erythematosus, myeloma, polycystic ovary syndrome, nephrotic syndrome, chronic renal failure, and other diseases. High serum total cholesterol increases the risk of coronary heart disease, stroke, and other cardiovascular diseases, and should be given first as a lifestyle intervention. Control the intake of cholesterol in the diet and limit the consumption of alcohol; at the same time, increase physical exercise, exercise appropriately according to one’s own situation, maintain ideal body weight, avoid overweight or obesity, and take statin drugs such as atorvastatin when necessary. High serum total cholesterol should go to the hospital and be treated under the guidance of the doctor.