Objective:To investigate the antilipemic effect of berberine combined with atorvastatin on rats with hypelipemia. Methods:The hypelipemia model was established by intragastric administration of lipid emulsion in rats. According to the level of total cholesterol (TC), the rats were randomly divided into 6 groups: model group, atorvastatin group, high-, middle- and low-dose berberine groups, and berberine+atorvastatin group. The antilipemic effect of each group was observed after 21 days, and the expressions of proprotein convertase subtilisin/kexin type 9 (PCSK9) and low density lipoprotein receptor (LDL-R) were detected by reverse transcriptase polymerase chain reaction (RT-PCR) and West blot methods. Results: TC level was signiifcantly decreased in atorvastatin group, high-dose berberine group and berberine+atorvastatin group, and that of low density lipoprotein (LDL) in atorvastatin group and berberine+atorvastatin group was also reduced notably. However, the decreased effects of TC and LDL in berberine+torvastatin group were superior to atorvastatin group. Both RT-PCR and West blot detection results revealed that PCSK9 expression went down markedly, while LDL-R expression up in the liver of rats in berberine+torvastatin group. Conclusion: Berberine exerts an antilipemic effect by inhibiting PCSK9 and increasing LDL-R, which can be reinforced by combination with atorvastatin.