OBJECTIVES:  To determine lipid target achievements among Omanis with high and very high risk status from the Centralized Pan-Middle East Survey on the undertreatment of hypercholesterolemia (CEPHEUS) according to the recent recommendations from the National Lipid Association. METHODS:  The Omani CEPHEUS study included 399 high and very high atherosclerotic cardiovascular disease (ASCVD) risk patients (≥18 years) on lipid lowering drugs (LLDs). The lipid fractions included high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-high density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (Apo B). RESULTS:  The overall mean age of the cohort was 58 ± 12 years, 48% (n=192) were female and 79% (n=316) had very high ASCVD risk status. Lipid target attainments for HDL-C, LDL-C, non HDL-C and Apo B were 41%, 26%, 35% and 35%, respectively. Very high ASCVD risk patients were less likely to attain lipid goal attainments compared to those with high ASCVD risk status (LDL-C (21 vs.