The correlation between stroke incidence and serum lipid level has been equivocal, and conventional lipid-lowering agents such as fibrates were ineffective for stroke prevention. Recent clinical trials for HMG-CoA reductase inhibitors(statins) have demonstrated 20-30% reduction in the risk of cerebrovascular events and mortality in the population with previous coronary heart disease(CHD). The beneficial effect of statins was most evident for thromboembolic stroke, and no significant increase in hemorrhagic events was noted. Equal reduction in stroke risk was observed between hyper- and normocholesterolemic populations, indicating the non-lipid mechanisms of statins. The efficacy and safety of statin treatment make it a promising approach for the management of both CHD and non-CHD patients at high risk of stroke, especially the elderly.