OBJECTIVES: To understand how clinicians in six European countries identify patients with statin intolerance (SI). METHODS: Clinicians from Austria, Belgium, the Czech Republic, Denmark, Portugal, and Switzerland were recruited for a web-based survey which was conducted between 2015 and 2016. Participants were asked how they identify patients with SI. Both specialists (cardiologists) and primary care physicians (60 per country) participated and were required to have treated ≥5 patients presenting with symptoms of SI in the previous year. All participants provided informed consent. RESULTS: Across Europe, 360 clinicians (139 specialists) participated in the survey. Clinicians reported an average of 63% (range across countries [RAC] 53–74%) of patients with potential SI presenting with muscle-related symptoms (MRS). Other common signs of potential SI reported by clinicians were persistent elevation in transaminases (13%, RAC 8–18%) and elevated creatine kinase (CK) without MRS (16%, RAC 11–22%). To establish whether MRS are due to SI, 79% of clinicians (RAC 70–83%) considered rechallenge after discontinuation of statin treatment to be required; other actions required as a minimum included trying at least two statins (82%; RAC 75–90%), rechecking elevated CK after modifying or stopping a statin (83%; RAC 77–93%), and excluding other potential causes of symptoms (64%; RAC 38–87%). Eighty percent of clinicians (RAC 68–90%) would apply additional criteria to establish SI in patients they considered to be at high risk of a cardiovascular event, most commonly trying other statins. Clinicians across these 6 countries estimated that on average 3% of their caseload have confirmed SI (RAC 2–5%). CONCLUSIONS: The majority of clinicians use rechallenge and try alternative statins to confirm a patient with MRS is SI.