Objectives: Hyperhomocysteinemia (Hhcy) is a known cardiovascular disease (CVD) risk factor. Observational studies had supported the role of lifestyle factors such as physical activity, diet and alcohol consumption in CVD prevention. Our study aimed to determine the relationship between Hhcy and lifestyle factors in general Chinese population.Methods: In this cross-sectional study, a total of 7135 adults (3320 men and 3815 women) aged 35 years or older were recruited from the rural Northeast China. Data on lifestyle factors, such as physical activities, sleep duration, current smoking and drinking status, dietary habits and familial factors were collected in interviews and laboratory examinations were performed by well-trained personnel.Results: Plasma total homocysteine (tHcy) level was higher in men than in women, and greater in the elderly than in other age groups. Subjects with Hhcy were more likely to be current smokers (men: OR 1.328, 95% CI 1.143-1.543, p<0.001; women: OR 1.465, 95% CI 1.214-1.767, p<0.001). Separately, men with Hhcy were more likely to have an education of primary school or below (OR 1.251, 95% CI 1.068-1.465, p=0.006) and less likely to eat more vegetables (OR 0.927, 95% CI 0.863-0.996, p=0.037) than the normal-tHcy participants. In women, participants with Hhcy were more likely to have longer sleeping time (>9h/d) (OR 1.677, 95% CI 1.292-2.177, p<0.001), low physical activity (OR 1.721, 95% CI 1.197-2.475, p=0.044) and increased diet score (OR 1.126, 95% CI 1.007-1.259, p=0.037) and less likely to be current drinkers (OR 0.488, 95% CI 0.297-0.802, p=0.005) than the normal-tHcy participants.Conclusion: Our study revealed that physical activity and current drinking status were not significantly associated with Hhcy in males, but inversely associated in females. In both genders, current smoking status and dietary habits were significantly associated with Hhcy. Our study supports existing recommendations for Chinese to maintain a physically active behaviors and healthy lifestyle habits. [ABSTRACT FROM AUTHOR]