Statins (HMG-CoA reductase inhibitors) are widely used lipid lowering agents. They effectively reduce LDL cholesterol (LDL-C), lower triglyceride levels and are very safe. Recent large-scale clinical trials have demonstrated that lowering LDL-C with statins substantially reduces the incidence of major coronary events in patients both with and without coronary artery disease (CAD). While all the clinical benefit of statins result primarily from their LDL-lowering effects, a variety of proposed statin mechanisms unrelated to LDL-lowering appears to further contribute to their benefits. Despite the statin database, the important clinical question persists: what is the ideal LDL level in CAD patients? Ongoing trials of high-dosage statins should confirm whether further reduction below the current LDL goal (<100 mg/dL) will provide worthy additional benefit. Unfortunately, up to 82% of proven CAD patients have not even achieved the current LDL goal, with up to 55% needing a >30 mg/dL reduction in LDL-C merely to reach the existing goal. These findings/considerations suggest that many patients are not receiving a statin or an inadequate dose.