Aim To explore the relationship between high density lipoprotein (HDL) particle, low density lipoprotein (LDL) particle and coronary artery lesions in premenopausal and postmenopausal female patients with coronary artery disease. Methods Data were collected from 79 female patients with coronary artery disease diagnosed by coronary angiography. According to whether menopause, the patients were divided into premenopausal group (n＝37) and postmenopausal group (n＝42). HDL particles and LDL particles were detected and analyzed by Lipoprint lipoprotein analyzer.The relationship between two lipoprotein particles and severity of coronary artery lesions was studied. Results Compared with the premenopausal group, large particle HDL concentration (102.6±45.2 mg/L vs 143.8±49.7 mg/L, P＜0.05) and its proportion (23.34%±8.26% vs 31.15%±7.98%, P＜0.05), and mean diameter of LDL particles (259.5±8.1 vs 265.7±3.7, P＜0.05) were decreased, small particle HDL concentration (124.0±76.8 mg/L vs 87.0±34.9 mg/L, P＜0.05) and its proportion (27.26%±12.34% vs 18.62%±6.53%, P＜0.05),Bü type proportion in LDL (73.8% vs 48.6%, P＜0.05), and Gensini score (50.88±26.46 vs 30.43±18.54, P＜0.05) were increased, in the postmenopausal group. In premenopausal group and postmenopausal group, large particle HDL concentration and the average diameter of LDL particles in patients with multivessel lesions were lower than those in patients with single vessel lesions, and the Gensini score was higher than that in patients with single vessel lesions. Large particle HDL concentration and the average diameter of LDL particles in postmenopausal group were lower than those in premenopausal group, and small particle HDL proportion and Gensini score in postmenopausal group were higher than those in premenopausal group. LDL particle size and large particle HDL concentration were negatively correlated with the Gensini score in the premenopausal group and the postmenopausal group. Conclusion Compared with the premenopausal group, large particle HDL concentration is lower, small particle HDL concentration is higher, the average diameter of LDL particle is smaller, and the degree of coronary artery lesions is more serious in the postmenopausal group. Large particle HDL concentration and the mean diameter of LDL are significantly correlated with the severity of coronary artery lesions.