<p>Dioxins are persistent organic pollutants generated during waste incineration that can potentially affect human health. Residents living near municipal solid waste incinerators (MSWIs) may be chronically exposed to dioxins, necessitating a comprehensive evaluation of their potential health effects. In this study, we evaluated the association between ambient and serum dioxin concentrations around MSWIs. The study included 65 female homemakers in their 40s and 50s, with 35 and 30 participants from the exposure (near MSWIs) and control (far from MSWIs) areas, respectively. Seventeen dioxin congeners in the serum samples were analyzed using high-resolution gas chromatography/mass spectrometry. A questionnaire was administered to determine the food preferences and general information. Ambient dioxin concentration data around the exposure and control areas were obtained from local government environmental impact assessment reports. Differences in total serum dioxin toxic equivalency concentrations (ΣTEQ) according to participant and food preference characteristics were compared. Principal component analysis (PCA) was conducted to evaluate the distribution patterns of ambient and serum dioxin concentrations. Serum ΣTEQ was significantly higher in the exposure area (4.548 pg WHO-TEQ/g lipid) than the control area (1.955 pg WHO-TEQ/g lipid). Total ambient dioxin ΣTEQ was higher in the exposure area. Significant differences were not observed in serum ΣTEQ according to the participants’ characteristics and food preferences. PCA results showed that ambient and serum dioxin concentrations had distinct distribution patterns but did not differ between the exposure and control areas. Serum ΣTEQ was significantly higher in residents in the exposure area, suggesting the influence of ambient dioxin levels near MSWIs.</p>