Spike betel (Piper aduncum L.) is one of the plant widely used as traditional medicine. There are still many unknown recorded pharmacological activities of Piper aduncum.This study aimed to observe the cholesterol lowering and vasorelaxant effect of P. aduncum ethanol extract (PAEE) in hypercholesterolemic model. Total cholesterol, triglyceride, LDL, HDL, NO level, Atherogenic Plasma Index (API), Systolic and Diastolyc Blood Pressure of hypercholesterolemic Wistar Kyoto (WKY) rats were used as parameters. Thirty adult male WKY rats were divided into six groups; each group contained five animals. Five groups were given high-fat diet foods, and PTU induced the animals to obtain hypercholesterolemia with a frequency of 1 time a day orally for 14 days. At the same time, the normal group was given destiled water and standard feed. On the 15th day the normal group was given destiled water; the high-fat diet group was given high-fat feed, the atorvastatin group was given an atorvastatin dose of 0.26 mg/kg BW, and the treatment group was given PAEE dose of 25, 50 and 100 mg/kg body weight for 14 days orally. Ethanol extract of P. aduncum significantly reduce total cholesterol levels and LDL, increase HDL levels and increase NO levels significantly (p<0.05). Doses of 50 and 100 mg/kg BW had the best effect on lowering total cholesterol, LDL level and provides a vasorelaxant effect, confimed by systolic and diastolic blood pressure examination.