Objective: Type 1 diabetes mellitus (T1D) and dyslipidemia (DLP) increase the risk of cardiovascular disease (CVD). The objective of this study was to evaluate the progress and perspective of dyslipidemia in young T1D patients . Materials and Methods: The study was cross-sectional and descriptive design. Medical records of T1D patients were followed at an endocrinology service from 2008-2014. The collected data included gender, age, duration of T1D, body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol (TC), HDL, LDL and triglycerides (TG). Results: 126 T1D patients were recruited: 69 male (54.8%) and 57 female (45.2%) with a mean of age 16.4 (±0.18) and 16.5 (±0.18), respectively. Diabetes duration and baseline HbA1c were 14.82 (±2.11) and 8.68 (±1.21), respectively. The HbA1c (average range of HbA1c 6.5% to 10.7%) increased significantly while following five years by 2.9% (p < 0.001). The prevalence of overweight and obese teens was increasing from the 1st year to the following five years later. In contrast, the underweight and healthy subjects were decreasing for the same subsequent years. Means of HbA1c were significantly higher among overweight and obese categories throughout following years. All lipid profile revealed significant increase during five years follow-up study. The prevalence of risk TC/HDL ratio (< 4.1) gradually raised in the last year follow-up by 52.1% comparing to the baseline risk ratio (0.8%). The study of TC/HDL ratio with BMI categories revealed that average T1D patients had an ideal ratio (n = 97) in the 1st year measurement. After five years follow-up study, the frequency of ideal ratio declined among all categories in the same rate. Risk TC/HDL ratio in the last year of the study showed that average group had more risk ratio measurements (n = 47) in contrast to the 1st year measurement (n = 1). The significant positive correlations were reported between HbA1c and DLP as shown in figure (r2 = 0.85). HbA1c and BMI percentile analyses during long follow-up years were How to cite this paper: Al Otaibi, F., Abdul-Rasool, M., Yaiesh, R. and Al Otaibi, N. 97very highly significant differences (p < 0.0001) between the categories BMI in each year and from one year to another. Conclusion: Attention must be given to control DLP and other comorbidities among T1D adolescents to decrease diabetes macrovascular and microvascular complications.