The Developmental Origins of Health and Disease theory suggests that early-life malnutrition is associated with an increased risk of chronic disease in adulthood. In this study, we aimed to analyze the association between exposure to the Chinese famine during fetal, childhood, and adolescence, while also exploring potential gender disparities in this association.From August 2018 to 2022 December, a 3-stage stratified random sampling method was employed to recruit 6916 eligible participants in Chongqing for this study. The participants were enrolled into 4 cohorts based on their birthdates: non-exposed, fetal-exposed, childhood-exposed, and adolescence-exposed. Participants were defined as having dyslipidemia according to the 2016 Chinese guideline for the management of dyslipidemia in adults, as well as self-reported dyslipidemia. In total, 6916 eligible participants were interviewed, including 1686 participants exposed when fetal, 1626 participants exposed during childhood, 1648 participants exposed during adolescence, and 1956 participants who had no exposure.The prevalence of dyslipidemia in the non-exposed, fetal-exposed, childhood-exposed, and adolescence-exposed cohorts was 21.43%, 25.00%, 24.38%, 22.52% in males and 20.00%, 36.57%, 34.60%, 32.59% in females, respectively. There was an increased risk of dyslipidemia among females exposed to the Chinese famine during the fetal (odds ratio [OR] = 1.613, 95% confidence interval [CI]: 1.179–2.205), childhood (OR = 1.857, 95% CI: 1.384–2.491), adolescence (OR = 1.531, 95% CI: 1.137–2.060) stage, However, no significant association was observed in male adults.Exposure to the Chinese famine during fetal, childhood, and adolescence stages increases the risk of dyslipidemia in adulthood in females, but not in males. The observed gender differences may be attributed to mortality advantage and son preference in China.