Objective: To analyze the association between fine particulate matter (PM2.5) exposure and dyslipidemia, and the potential modifying role of dietary factors in children and adolescents in rural China. Methods: A multi-stage cluster random sampling method was applied to conduct questionnaire survey, biochemical measurements, and physical examination in children and adolescents aged 8 to 15 years in 103 key surveillance counties where the Nutrition Improvement Program for Rural Compulsory Education Students was conducted. The average PM2.5 concentration in previous 3 years was used as the long-term exposure level. The linear mixed-effect model was used to evaluate the association between PM2.5 exposure and dyslipidemia. Stratified analyses by dietary factors were conducted to analyze their potential modifying effects. Results: A total of 10 788 children and adolescents were included, including 5 391 boys (49.97%) and 5 244 primary school students (48.61%). The annual PM2.5 exposure level was (30.36±10.62) µg/m³, and the prevalence rate of dyslipidemia was 21.84%. Higher PM2.5 exposure was significantly associated with the increased risk for dyslipidemia (OR=1.501, 95%CI: 1.028-2.192), with stronger associations observed in boys, junior high school students, and those attending schools in county towns. Stratified analyses indicated that no significant association was observed between high PM2.5 exposure and dyslipidemia in children and adolescents with greater vegetable intake diversity. Conclusions: High level of PM2.5 exposure increased the risk for dyslipidemia in children and adolescents. Greater diversity of vegetable intake might play a modifying role in the adverse association between PM2.5 exposure and dyslipidemia. 目的： 分析我国农村地区儿童青少年细颗粒物（PM2.5）暴露与血脂异常的关联，同时探索饮食因素的修饰效应。 方法： 采用多阶段整群随机抽样方法，在实施农村义务教育学生营养改善计划的103个重点监测县收集8~15岁儿童青少年的问卷、生化和体格检查等数据，以研究对象参与调查前3年的PM2.5浓度作为长期暴露水平，采用线性混合效应模型分析PM2.5暴露与儿童青少年血脂异常的关联，根据饮食因素分层后探索其潜在的修饰效应。 结果： 纳入10 788名儿童青少年，其中男生5 391名（49.97%），小学生5 244名（48.61%），PM2.5年均暴露量为（30.36±10.62）µg/m3，血脂异常检出率为21.84%。PM2.5暴露与儿童青少年血脂异常风险升高有关（OR=1.501，95%CI：1.028~2.192），男生、初中生、学校位于县城的儿童青少年风险更高。分层分析显示，在蔬菜摄入种类较多的亚组中未发现高PM2.5暴露与儿童青少年血脂异常之间的关联。 结论： 高PM2.5暴露会升高儿童青少年血脂异常的风险，较高的蔬菜摄入多样性在PM2.5暴露与儿童青少年血脂异常中存在一定修饰效应。.