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Background The mechanisms of intracranial aneurysms (IAs) formation and rupture remain elusive.Elevated serum levels of Lipoprotein(a) [Lp(a)] are associated with many vascular diseases.However, there are limited data demonstrating a relation between Lp(a) and patients with IAs.Methods An age-and sex-matched case-control study was conducted.Demographic data and plasma samples were obtained from 117 patients with angiographically proven IAs and age and sex-matched healthy controls.Serum Lp (a), fibrinogen, total cholesterol (TC), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and creatinine levels in IA patients and healthy subjects were studied.Results Patients with IA had significantly higher Lp(a) serum levels (median, 12 mg/dL, range,2.92-93.77 mg/dL) when compared with healthy individuals (median, 10.7 mg/dL, range, 2.1-51.6 mg/dL)(P=0.030).There were no significant differences of Lp(a) between the male patients and control subjects(median, 11.5 versus 10.8 mg/dl, P=0.606).However, serum Lp(a) levels were increased significantly in female patients with IA (median, 14.3mg/dL, range, 3.3-4.37 mg/dL) than in healthy female individuals(median, 9.4 mg/dL, range, 2.9-5.14 mg/dL) (P=0.001).A significant correlation existed between fibrinogen and lipoprotein (a) in female patients with IAs (r=0.463, p<0.0001).Conclusion: There are increased serum levels of Lp(a) in female patients with IA.The raised Lp(a) positively correlated with fibrinogen concentrations.The underlying mechanism requires further exploration.