Although hyperlipidemia clearly plays a role in developing cardiovascular disease, the 10% of the population with the highest LDL levels account for only 20% of cardiovascular disease events. Thus, in order to significantly reduce the burden of cardiovascular disease, subjects with only modest dyslipidemia need to be treated with lipid-lowering therapy. Current guidelines have recommended aggressive lipid-lowering therapy in subjects at high risk of cardiovascular disease. The rationale behind this and treatment options to achieve target lipid goals are discussed.