Objective This study aims to discuss the impact of chyle blood on the results of blood routine tests in patients with hyperlipidemia. Methods This study randomly included 40 hyperlipidemia patients who received treatment in our hospital from January 2022 to January 2024 and were recorded as the trial group. In addition, 40 healthy subjects who underwent blood routine examinations at our hospital during the same period were selected as the control group, with a total of 80 subjects. The differences in various indicators between the two groups of patients after plasma exchange and before exchange were compared. Results The results of this study showed that the average red blood cell volume, hematocrit, and red blood cell count of the trial group's blood samples after plasma exchange were not statistically significant before plasma exchange (P>0.05). Hemoglobin, mean hemoglobin level, mean hemoglobin concentration, platelet count, white blood cell count, and mean platelet volume were lower compared to before plasma exchange, while neutrophils were higher compared to before exchange (P<0.05). There was no significant difference between the blood samples of the control group after replacement and before replacement (P>0.05). Conclusions In blood routine tests, chyle blood samples from patients with hyperlipidemia seriously affect the test results. It is recommended to perform plasma exchange on the sample before testing, which can effectively improve the accuracy of the detection and provide data reference for relevant diagnosis and treatment.