Dyslipidemias are major risk factors for coronary artery disease (CAD). High levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (NHDL) cholesterol, and triglycerides are key contributors to atherosclerosis. Epidemiological studies in India show increasing prevalence of these lipid abnormalities, with higher rates in northern and western cities. The ICMR-INDIAB study found hypercholesterolemia (≥200 mg/dl) prevalence ranging from 4.6% to 50.3%, with higher rates in Kerala, Goa, and Himachal Pradesh. NHDL cholesterol is also a significant risk factor, with higher levels in developed states. Triglycerides are elevated in many Indian populations, with higher prevalence in eastern and southern states. Global trends show a shift in high cholesterol prevalence from Europe and North America to South and Southeast Asia. The PURE study identified NHDL cholesterol as the most important CAD risk factor. In India, the prevalence of low HDL cholesterol is high, with over 66% of the population having low levels. While total cholesterol levels have slightly increased in India since 1980, they do not correlate with CAD incidence as strongly as in developed countries. The role of HDL cholesterol as a causal risk factor is debated, with it being more of a marker. The study highlights the need for nationwide surveys and prospective studies to assess the risk of dyslipidemias in India. Efforts to raise awareness, screen for lipid abnormalities, and initiate appropriate treatment are essential to reduce cardiovascular mortality and morbidity in the country.Dyslipidemias are major risk factors for coronary artery disease (CAD). High levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (NHDL) cholesterol, and triglycerides are key contributors to atherosclerosis. Epidemiological studies in India show increasing prevalence of these lipid abnormalities, with higher rates in northern and western cities. The ICMR-INDIAB study found hypercholesterolemia (≥200 mg/dl) prevalence ranging from 4.6% to 50.3%, with higher rates in Kerala, Goa, and Himachal Pradesh. NHDL cholesterol is also a significant risk factor, with higher levels in developed states. Triglycerides are elevated in many Indian populations, with higher prevalence in eastern and southern states. Global trends show a shift in high cholesterol prevalence from Europe and North America to South and Southeast Asia. The PURE study identified NHDL cholesterol as the most important CAD risk factor. In India, the prevalence of low HDL cholesterol is high, with over 66% of the population having low levels. While total cholesterol levels have slightly increased in India since 1980, they do not correlate with CAD incidence as strongly as in developed countries. The role of HDL cholesterol as a causal risk factor is debated, with it being more of a marker. The study highlights the need for nationwide surveys and prospective studies to assess the risk of dyslipidemias in India. Efforts to raise awareness, screen for lipid abnormalities, and initiate appropriate treatment are essential to reduce cardiovascular mortality and morbidity in the country.