Hyperlipidaemia (HLP) is a disorder with disturbed lipid metabolism and a major risk factor for various diseases. This study focused on the effect of moxibustion with seed-sized moxa cone on HLP and the relative metabolites and pathways. Levels of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDC-C) in healthy controls (HC), HLP patients, HLP patients before (BMT) and after (AMT) moxibustion treatment were measured. Using the liquid chromatograph-mass spectrometry (LC-MS) technique, we detected the plasma metabolites in the aforementioned groups. Pathway analysis was performed for the differential metabolites. Results revealed significantly high levels of TC, TG and LDC-C and low levels of HDC-C were measured in HLP compared to HC. After moxibustion treatment, the levels of TC and TG significantly decreased. Total 87 and 51 differential metabolites were identified in HLP vs HC and AMT vs BMT, respectively, and 21 were common differential metabolites. The differential metabolites in HLP vs HC and AMT vs BMT both significantly enriched in the pathways of Glycerophospholipid metabolism and Sphingolipid metabolism. In conclusion, moxibustion with seed-sized moxa cone effectively improved HLP, might be by affecting the levels of TC and TG, and the regulating of the Glycerophospholipid metabolismand Sphingolipid metabolism pathways.