Lipid peroxidation products, malondialdehyde (MDA), 4-hydroxynonenal (4-HNE) and [Formula: see text], were determined in the plasma and urine of patients with Lyme arthritis and healthy people. The group consisted of 19 patients with Lyme arthritis (mean age 47 years) and the control group consisted of 16 healthy individuals (mean age 38 years). Diagnosis of Lyme disease was confirmed by epidemiological anamnesis, clinical manifestation of arthritis and serological examinations. Lipid peroxidation was estimated by the measurement of aldehydes (MDA and 4-HNE, determined by high-performance liquid chromatography [HPLC]) and prostaglandin derivatives (8 - isoPGF(2a), determined by liquid chromatography/mass spectrometry [LC/MS]). MDA and 4-HNE levels were increased about 2-4-fold in the plasma, while in the urine, the increases were about 2-fold. More significant increases were noted for the 8 - isoPGF(2a) total plasma level, which was enhanced over 4-fold, and for the urine 8 - isoPGF(2a) level, which was increased over 8-fold. The 8 - isoPGF(2a) total plasma level consists of free and esterified form. During infection, the ratio of free to esterified form is significantly smaller compared to healthy people. The ratio of free to esterified form of 8 - isoPGF(2a) may be a useful indicator of Lyme arthritis. Moreover, the complementarities of three lipid peroxidation product levels may be helpful in the diagnosis of Lyme arthritis.