Objective: To assess long-term reduction of cardiovascular (CV) events and cost-effectiveness of the use of rosuvastatin (RSV), atorvastatin (ATV), simvastatin (SIM) and pravastatin (PRA) in Mexican patients over 55 years old. Methods: Efficacy data from STELLAR clinical trial (total cholesterol -TC-, LDL-C; HDL-C, triglycerides -TG-) was used as input to the model. Based on Framingham risk equations, 4 gender/risk cohorts were traced for 20 years (4-year Markov cycles) with 55-76 year old patients in order to predict primary and secondary CV events. Quarterly titration in year one was set up to a maximum dose of 20 mg RSV, 80 mg ATV, 80 mg SIM and 40 mg PRA based on TC target, whereas risk was calculated using average TC:HDL-C ratio of the 1000 simulated patients, with adjustment for Framingham's hypothesized over-prediction of Mexican risk. The economic analysis was done under private sector perspective with a 5% and 1.5% discount rate for costs and benefits, respectively. Unitary costs were obtained from NADRO (local wholesaler). Mexican Institute of Social Security costs and data from a Delphi Panel were used to estimate CV diseases' private costs. Disability-adjusted life years gained (DALYs) for each treatment regimen were estimated. Results are shown in natural units, while costs are expressed in US dollars. Sensitivity analysis included threshold, one-way scenarios and probabilistic analysis. Results: RSV 10mg for the 20-year horizon resulted in less primary and secondary events (197) and deaths (42), per 1000 patients, more DALYs (14.97) and lower per-patient treatment costs ($8134.57) than other statins on equivalent doses. Hence, RSV 10mg is highly cost-effective with a cost per DALYs gained of $16,802.15 than comparators. Sensitivity analysis showed the robustness of results. Conclusion: RSV is a cost-effective strategy: it yields fewer CV events, resulting in fewer deaths and significant economic saving for both patients and institutions.