Statins, or HMG-CoA reductase inhibitors, are widely used to treat hypercholesterolemia. They competitively inhibit HMG-CoA reductase, reducing LDL levels more effectively than other cholesterol-lowering drugs and lowering triglyceride levels in hypertriglyceridemic patients. Statins are well tolerated and have a good safety record. Clinical trials have consistently shown that statins reduce the relative risk of major coronary events by approximately 30% and produce a greater absolute benefit in patients with higher baseline risk. Proposed mechanisms include favorable effects on plasma lipoproteins, endothelial function, plaque architecture and stability, thrombosis, and inflammation. The clinical benefits of statins may extend beyond lipid-lowering, potentially broadening their indication to antiatherogenic agents. Key aspects of statin pharmacology, clinical trials, and proposed mechanisms of action are discussed, along with adverse effects and monitoring. Statins are recommended for patients with atherosclerosis, diabetes, multiple risk factors, moderate hypertriglyceridemia, and low HDL levels. Future research will focus on the benefits of statins in acute coronary syndromes and stroke prevention.Statins, or HMG-CoA reductase inhibitors, are widely used to treat hypercholesterolemia. They competitively inhibit HMG-CoA reductase, reducing LDL levels more effectively than other cholesterol-lowering drugs and lowering triglyceride levels in hypertriglyceridemic patients. Statins are well tolerated and have a good safety record. Clinical trials have consistently shown that statins reduce the relative risk of major coronary events by approximately 30% and produce a greater absolute benefit in patients with higher baseline risk. Proposed mechanisms include favorable effects on plasma lipoproteins, endothelial function, plaque architecture and stability, thrombosis, and inflammation. The clinical benefits of statins may extend beyond lipid-lowering, potentially broadening their indication to antiatherogenic agents. Key aspects of statin pharmacology, clinical trials, and proposed mechanisms of action are discussed, along with adverse effects and monitoring. Statins are recommended for patients with atherosclerosis, diabetes, multiple risk factors, moderate hypertriglyceridemia, and low HDL levels. Future research will focus on the benefits of statins in acute coronary syndromes and stroke prevention.