OBJECTIVES: To determine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and to assess risk factors associated with statin use among US adults with ASCVD. METHODS: Using the National Health and Nutrition Examination Survey (NHANES) data over three exam cycles (2011-16), ASCVD prevalence was calculated among adult participants (20+ years). ASCVD included myocardial infarction (MI), coronary heart disease (CHD), stroke and angina and was obtained via a self-report questionnaire. Current statin use (monotherapy and combination therapy) was obtained from questionnaires and a medication inventory. Multivariate logistic regression was used to examine the association of risk factors with statin use. All analyses accounted for the NHANES complex sampling design. RESULTS: Among US adults in NHANES, 7.8% of participants reported having ASCVD, with 3.3% reporting MI, 3.4% CHD, 2.8% stroke and 2.1% angina. Among those with ASCVD, 62.9% were taking statins, of which only 27% were at LDL-C <70 mg/dL. In adjusted models, participants reporting a history of CHD or type II diabetes had 2.58 (95% CI (1.68, 3.97); p<0.001 and 1.60 (1.03, 2.49); p=0.04 times greater odds of statin use, respectively, as well as those reporting a family history of MI (1.46 (1.01, 2.13); p=0.05). Increasing age categories (45-64 and 65+ versus <45) were significantly associated with approximately 3.5 times higher odds of taking statins (p=0.002 and p=0.004, respectively). Hispanic ethnicity (versus non-Hispanic white; 0.54 (0.34, 0.86), p=0.01)) and female sex (versus male; 0.61 (0.40, 0.92), p=0.02) were all associated with significantly lower odds of statin use. CONCLUSIONS: Over half of US adults who reported having ASCVD were taking statins, yet only one-fourth of those were at goal. Factors significantly associated with statin use included demographic, comorbidities, and healthcare-related factors. Greater efforts should be made to adhere to American Heart Association/American College of Cardiology guidelines regarding statin use for all individuals with existing ASCVD.