The statins are among the most widely used pharmaceutical drugs and have shown to be extremely effective in the treatment of dyslipidaemia. The statins are effective in the primary and secondary prevention of coronary artery disease, in peripheral and cerebral vascular disease and in a wide variety of patient groups. In addition they have a beneficial effect on the vascular wall and atherosclerotic process, which is not related to their cholesterol-lowering effect. Despite their potency they are relatively well tolerated, with adverse effects mostly as a result of muscle and liver involvement. Some of the issues relating to efficacy and detrimental effects are discussed briefly.