Objective. To determine the association of use of tumor necrosis factor-alpha (TNF-alpha) inhibitors with differences in lipid levels in patients with rheumatoid arthritis (RA). Methods. We studied 807 patients with incident RA to compare differences in lipid levels in TNF-alpha inhibitor users versus nonusers, with adjustment for relevant covariables. Results. TNF-alpha inhibitor use was not associated with differences in levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides, LDL:HDL, or TC:HDL compared to nonusers. Conclusion. Use of TNF-alpha inhibitor was not associated with differences in lipid levels in patients with RA. (First Release April 1 2012; J Rheumatol 2012;39:946-8; doi:10.3899/jrheum.111093)