Objective: The study aimed to investigate the role and level of resistin and correlation some biochemical parameters (ox-LDL, Hcy, LDL-C, TC, HDL, BMI and lipid peroxidation MDA), Antioxidant (GSH, A, C, E), also we studied familial hypercholesterolemia (FH) to investigate the effects of MTHFR gene mutation. Material and methods: 64 patients (33females and 31males) who attend Rizgary teaching hospital, Erbil, Iraq, between November 2014 to March 2015, the study included biochemistry parameter analysis and genetic study MTHFR gene (exon4) for females with (hypercholesterolemia and FH). Results: hypercholesterolemia and FH are cause of increase in (LDL-C, HDL-C, ox-LDL, Hcy, MDA(levels and the results show increase in resistin level and correlation with BMI , as well as the results show decrease in antioxidants levels. The genetic study for MTHFR gene the results show mutations in sequence of (exon4) for the gene which show (Pro (777) deletion (C) and Glu (784) deletion (A) for female patient with hypercholesterolemia) and (Lys (10844) deletion (A) and Asp (10877) deletion (G) for female with FH which leading frame shift or protein truncation). Conclusion: Hypercholesterolemia and FH are cause of increase in (resistin, LDL-C, HDL-C, ox-LDL, Hcy, MDA) levels and correlation with BMI, as well as decrease in antioxidants levels. Also MTHFR gene mutation (exon4) has an effect of patients with (hypercholesterolemia and FH).