To evaluate the role of serum lipid profile on fundus changes in hypertensive patients and to correlate the grades of hypertensive retinopathy with components of lipid profile. Material and method: A cross-sectional prospective study was carried out in 100 patients attending the Ophthalmology department who were diagnosed to have systemic hypertension. The stage of hypertension was classified according to JNC 7 criteria. Patients suffering from diabetes, myopia, having hazy media and other posterior segment disorders and giving consent were excluded from the study. Their detailed ophthalmological examination was carried out and also their evaluation by the physician was done. All the patients were investigated for fasting serum lipid profile done by endpoint method using a spectrophotometer. Fasting was for 8 hours. Hypertensive fundus changes were evaluated using the Keith – Wagener, and Barker (KWB) Classification. Discussion: Out of 100 patients with essential hypertension, 70 (70%) had retinopathy and the remaining 30 (30%) patients had no retinopathy. Mean age having retinopathy was 63 years. All patients having hypertension for more than 10 years had retinopathy. The severity of hypertension correlated well with severity of retinopathy in our study (p< 0.0009). No sex preponderance toward developing retinopathy was found (p< 0.58). A positive correlation of hypertensive retinopathy was found with total cholesterol(p<0.0001), low-density lipoprotein (LDL)-cholesterol (p<0.0001), serum triglycerides(p<0.0001), and a low density lipoprotein: high-density lipoprotein(LDL:HDL) ratio(p<0.0008). Conclusion: This study helps to assess the association between hypertensive retinopathy in patients with essential hypertension with an altered serum lipid profile, with the aim of preserving vision.