BACKGROUND:The traditional Korean diet is relatively high in carbohydrate and low in fat and protein compared with diets of non-Asian populations. In recent decades, the rapid economic growth in Korea has led to lifestyle and dietary changes, with an increase in the prevalence of dyslipidemia, a risk factor for chronic diseases. OBJECTIVE:To examine the association between a low carbohydrate diet (LCD) score and dyslipidemia in Korean adults. DESIGN:The Korea National Health and Nutrition Examination Survey is an ongoing nationally representative population-based cross-sectional survey that is conducted annually. PARTICIPANTS/SETTING:A total of 12,199 Korea National Health and Nutrition Examination Survey participants aged ≥20 years from 2010 to 2016 were included in this study. MAIN OUTCOME MEASURES:Individual components of dyslipidemia, such as hypercholesterolemia, hypertriglyceridemia, and low high-density lipoprotein cholesterol levels, were defined based on fasting blood test results. STATISTICAL ANALYSES:Participants were classified by sex into quintiles of LCD scores calculated using 1-day 24-hour dietary recall data. A multivariable logistic regression model was used to examine the association between LCD score and each dyslipidemia component after adjusting for potential confounders. RESULTS:A higher LCD score was significantly associated with higher odds of hypercholesterolemia (odds ratio 1.36, 95% CI, 1.05 to 1.78; P for trend=0.031) and lower odds of low high-density lipoprotein cholesterol levels (odds ratio 0.72, 95% CI 0.55 to 0.94; P for trend=0.002) in women. However, in men, higher LCD scores were significantly associated with lower odds of hypertriglyceridemia (odds ratio 0.70, 95% CI 0.52 to 0.95; P for trend=0.012). More specifically, animal-based LCD scores were negatively associated with the odds of hypertriglyceridemia (odds ratio 0.65, 95% CI 0.48 to 0.87; P for trend=0.010) in men. CONCLUSIONS:These results suggest that the complicated and integrated effects of macronutrient composition on individual lipid components should be considered for preventing dyslipidemia in Korean adults.