Human sebaceous glands are found over the entire skin surface (except the palms and soles).Its function is to secrete sebum. Sebum production is continuous and is not controlled by neural mechanisms. Acne is a chronic inflammatory disease of the pilosebaceous units.The pathophysiologic factors that influence the development of acne are altered follicular growth and differentiation, sebaceous gland hyperplasia with seborrhea, P. acnes colonization of the follicle and inflammation. The aim was to evaluate serum lipids and sex hormones in female patients with different grades of acne. 80 female patients were used with acne vulgaris (Mild ,Moderate ,Severe and Very severe acne) 20 patients each The results showed a significant decrease of HDL-C,increase of LDL-C and revealed a significant increase of free testosterone and decrease of DHEA-S .there is a significant increase of free testosterone in severe and very severe acne groups in comparison with the controls. Further studies are recommended to assess the relation between serum lipids and sex hormones in different grades of acne.