Statins are best-known for their lipid-lowering effects and have been shown to significantly impact the natural progression of coronary atherosclerosis. The mechanism through which they exert this effect is thought to be primarily due to their ability to reduce low-density lipoprotein cholesterol levels. However, there is increasing evidence that statins exert a myriad of other beneficial effects on the vascular wall, thus altering the course of atherosclerotic disease. This article will review the prevention trial literature as it pertains to the effects of statin therapy on atherosclerosis.