Background: Thyroid dysfunction may contribute to lipids metabolic disorders. Zinc-alpha-2-glycoprotein (ZAG) function comes from its specific lipolytic action. This study aimed to find the association of serum ZAG levels with thyroxin and lipid profile in patients with hyperthyroidism before and after carbimazole treatment. Patients and methods: This study was conducted as a case-cohort study done on 23 patients suffering from typical symptoms of hyperthyroidism. In addition, 23 apparently healthy individuals were chosen as a control group. All patients were selected from Internal medicine department, Zagazig University Hospitals. Results: The present study showed fasting plasma glucose levels and SBP were significantly higher among case group. The difference in lipid profile in case group before and after treatment with carbimazole.There was significant higher levels in total cholesterol and TG Levels after treatment. The difference in lipid profile in case group before and after treatment with carbimazole. There was significant reduction in HDL Levels after treatment. While LDLwas significant higher after the treatment. Significant reduction in ZAG levels after treatment with carbimazole in case group. Conclusion: ZAG has a novel role in lipid metabolism as it has specific lipolytic action so it has a potential role in body weight regulation, protect against fatty liver by ameliorating hepatic steatosis, insulin resistance and inflammation.