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Background and purpose: This study aimed at determining the relationship between the body mass index and pattern of fat distribution with blood lipid serum among secondary school girls. Materials and methods: A total of 780 students who volunteered to participate in this study signed an informed consent form. Among them 155 were active, 340 were inactive and 285 students were moderately active. The participants in the last group were excluded from the study. Sample size table of Cohen et al (2001) was used and the students were randomly divided into two groups of active (51 students) and inactive (55 students). Height, weight, waist perimeter and pelvic perimeter were measured in order to determine the body mass index and the pattern of fat distribution in the body. Then fasting blood test was done to examine the levels of LDL, HDL, triglycerides, and cholesterol. The Pearson correlation and t-test were applied to analyze the data. Results: The results showed a significant difference between the two groups regarding the body mass index and fat distribution pattern (P< 0.05). However, the difference between two groups for LDL and HDL, triglycerides and cholesterol was not significant. Conclusion: This study indicates a significant relationship between body mass index and the pattern of fat distribution and blood fats which are important factors influencing heart disease, but based on the extent of body activity, no difference was seen between the two groups.