Objective: Evaluate the opinions of Canadian physicians and patients towards adherence with cholesterol treatment. Methods: A convenience sample of 362 general practitioners recruited across Canada completed a physician questionnaire. A minimum of 20 statin patients per physician completed questionnaires during normally scheduled visits. An independent third party collected and analyzed the data. Each physician received aggregate practice level and entire patient cohort data. Results: A total of 13,508 patients participated; 42% of cohort was 65 years or older. Reported medical conditions: 55% high BP, 59% high LDL, 27% heart problems, 29% diabetes, 18% obesity, 6% stroke. Patient reasons for stopping statins: 26% don't like taking medication, 20% needed more information on side effects, 14% improved their diet or lost weight, 10% needed more information on benefits of statins. Physician opinions on why patients have poor compliance to statins: 80% resistance to taking medications, 68% side effects of medication, 64% lack understanding of the benefits of statin therapy, 25% achieved weight loss or diet improvements. Patient reported factors that would motivate them to stay on therapy: 36% seeing a printout of my levels, 32% knowing more about risks of high cholesterol, 31% having the doctor discuss cholesterol in more detail, 25% knowing more about my medication. Physician opinions on key patient compliance motivators: 83% discussing cholesterol issues with patients, 79% follow up discussion on levels, 72% discussing medications, 61% diet and lifestyle support program. Medication change preference if not reaching LDL target – patient vs. physician: Increase dose 51% vs. 75%, change statin 40% vs. 7%, add another drug 9% vs. 19%. Conclusion: Differences exist in physician and patient reported reasons for adherence to statin therapy. Understanding these differences may assist physicians to counsel their patients more effectively and possibly improve adherence.