Moderate- and high-intensity statins are recognized by national and international organizations as first-line drug therapy for the treatment of elevated atherogenic cholesterol levels. Yet some patients are unable to tolerate maximal statin dosages due to adverse effects such as myopathy and elevated liver enzymes, making atherogenic cholesterol goal achievement with statin monotherapy even more difficult. Patients with true statin intolerance are difficult to diagnose and manage therapeutically; in this setting, clinicians are forced to adjust dosing, change concomitant therapies that may contribute to adverse events, utilize a lower dose statin, or combine lower dose statins with a non-statin therapy. In order to minimize the risk of atherosclerotic cardiovascular disease (ASCVD), it is necessary to identify high-risk individuals with statin intolerance. In addition, managing statin intolerance is crucial in optimizing guideline-directed medical therapy in patients with hypercholesterolemia. This workshop will review strategies that address statin intolerance: including symptom management, medication choices and titration, monitoring patients on statins, and the role of PCSK9 inhibitors.