A new procedure for the determination of sterols in serum samples is proposed. The system consists of coating a Solid Phase Microextraction (SPME) microfiber in headspace mode with the derivatizing agent N,O-bis(trimethylsilyl)trifluoracetamide (BSTFA) and then applying this coated fiber to the simultaneous extraction and derivatization of three precursors in the cholesterol biosynthesis pathway (desmosterol, lathosterol and lanosterol) and two phytosterols (sitosterol and sitostanol) in serum samples. Optimization of the analytical procedure via the application of an experimental design, a study of matrix effects, and an analysis of serum pool samples are all described and discussed.