High lipoprotein(a) [Lp(a)] levels are a major cause of atherosclerotic cardiovascular disease (ASCVD) and are the most common inherited dyslipidemia and strongest genetic risk factor for ASCVD. Lp(a) remains a risk factor even when LDL-C levels are within target and lifestyle modifications are followed. Recent evidence supports its role in multiple disease states, and clinical guidelines recommend universal Lp(a) testing. However, there is a gap in implementing recommendations for CVD prevention in those with high Lp(a). Targeted therapies to lower Lp(a) are in phase 3 clinical development. This review focuses on identifying and managing patients with high Lp(a), emphasizing the clinical value of measuring Lp(a) and its role in determining CVD risk. Lp(a) is a pro-atherogenic, pro-inflammatory, and pro-thrombotic particle, and its levels are genetically determined, with significant racial and ethnic variations. Lp(a) testing is recommended by multiple guidelines, including the AHA/ACC, ESC/EAS, and NLA. Lp(a) screening is important for CVD risk assessment, as it can reclassify individuals to higher risk categories. Lp(a) levels are associated with increased CVD risk, including CAD, stroke, and CAVS. Lp(a) testing is recommended for individuals with a family history of premature CVD or high Lp(a). Lp(a) levels are influenced by genetic and environmental factors, and there are challenges in standardizing Lp(a) assays. Lp(a) testing is cost-effective and can be done via direct-to-consumer assays. Lp(a) levels are associated with increased CVD risk, and Lp(a) screening is important for risk mitigation. Lp(a) testing is recommended for individuals with high Lp(a) levels, and Lp(a) levels should be measured in those with a family history of premature CVD or high Lp(a). Lp(a) testing is important for CVD risk assessment, as it can reclassify individuals to higher risk categories. Lp(a) levels are associated with increased CVD risk, and Lp(a) screening is important for risk mitigation. Lp(a) testing is recommended for individuals with high Lp(a) levels, and Lp(a) levels should be measured in those with a family history of premature CVD or high Lp(a). Lp(a) testing is important for CVD risk assessment, as it can reclassify individuals to higher risk categories. Lp(a) levels are associated with increased CVD risk, and Lp(a) screening is important for risk mitigation. Lp(a) testing is recommended for individuals with high Lp(a) levels, and Lp(a) levels should be measured in those with a family history of premature CVD or high Lp(a). Lp(a) testing is important for CHigh lipoprotein(a) [Lp(a)] levels are a major cause of atherosclerotic cardiovascular disease (ASCVD) and are the most common inherited dyslipidemia and strongest genetic risk factor for ASCVD. Lp(a) remains a risk factor even when LDL-C levels are within target and lifestyle modifications are followed. Recent evidence supports its role in multiple disease states, and clinical guidelines recommend universal Lp(a) testing. However, there is a gap in implementing recommendations for CVD prevention in those with high Lp(a). Targeted therapies to lower Lp(a) are in phase 3 clinical development. This review focuses on identifying and managing patients with high Lp(a), emphasizing the clinical value of measuring Lp(a) and its role in determining CVD risk. Lp(a) is a pro-atherogenic, pro-inflammatory, and pro-thrombotic particle, and its levels are genetically determined, with significant racial and ethnic variations. Lp(a) testing is recommended by multiple guidelines, including the AHA/ACC, ESC/EAS, and NLA. Lp(a) screening is important for CVD risk assessment, as it can reclassify individuals to higher risk categories. Lp(a) levels are associated with increased CVD risk, including CAD, stroke, and CAVS. Lp(a) testing is recommended for individuals with a family history of premature CVD or high Lp(a). Lp(a) levels are influenced by genetic and environmental factors, and there are challenges in standardizing Lp(a) assays. Lp(a) testing is cost-effective and can be done via direct-to-consumer assays. Lp(a) levels are associated with increased CVD risk, and Lp(a) screening is important for risk mitigation. Lp(a) testing is recommended for individuals with high Lp(a) levels, and Lp(a) levels should be measured in those with a family history of premature CVD or high Lp(a). Lp(a) testing is important for CVD risk assessment, as it can reclassify individuals to higher risk categories. Lp(a) levels are associated with increased CVD risk, and Lp(a) screening is important for risk mitigation. Lp(a) testing is recommended for individuals with high Lp(a) levels, and Lp(a) levels should be measured in those with a family history of premature CVD or high Lp(a). Lp(a) testing is important for CVD risk assessment, as it can reclassify individuals to higher risk categories. Lp(a) levels are associated with increased CVD risk, and Lp(a) screening is important for risk mitigation. Lp(a) testing is recommended for individuals with high Lp(a) levels, and Lp(a) levels should be measured in those with a family history of premature CVD or high Lp(a). Lp(a) testing is important for C