Elevated blood lipid levels are well-established risk factors for cardiovascular disease (CVD). The current classification and treatment guidelines for hyperlipidemia are based on the National Cholesterol Education Panel’s (NCEP) Adult Treatment Program-3 (ATP-III) guidelines. Statins are the preferred class of drugs to lower elevated low-density lipoprotein cholesterol (LDL-C), but other classes such as ezetimibe, fibrates, niacin, and dietary supplements can be used to augment or substitute statins. Recent research has raised questions about the aggressiveness of ATP-III guidelines, and new guidelines from ATP-IV are expected soon. In the meantime, physicians face uncertainty about target LDL-C levels, the pharmacological treatment of high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels, and the best methods to achieve these targets. The article discusses the significance of hyperlipidemia, diagnosis, classification, evaluation, and treatment, including the use of alternative risk factors and complementary products. It also addresses unanswered questions and controversies, such as the optimal LDL-C target and the balance between benefit and risk in statin therapy.Elevated blood lipid levels are well-established risk factors for cardiovascular disease (CVD). The current classification and treatment guidelines for hyperlipidemia are based on the National Cholesterol Education Panel’s (NCEP) Adult Treatment Program-3 (ATP-III) guidelines. Statins are the preferred class of drugs to lower elevated low-density lipoprotein cholesterol (LDL-C), but other classes such as ezetimibe, fibrates, niacin, and dietary supplements can be used to augment or substitute statins. Recent research has raised questions about the aggressiveness of ATP-III guidelines, and new guidelines from ATP-IV are expected soon. In the meantime, physicians face uncertainty about target LDL-C levels, the pharmacological treatment of high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels, and the best methods to achieve these targets. The article discusses the significance of hyperlipidemia, diagnosis, classification, evaluation, and treatment, including the use of alternative risk factors and complementary products. It also addresses unanswered questions and controversies, such as the optimal LDL-C target and the balance between benefit and risk in statin therapy.