OBJECTIVES: The main objective of the current study is to assess the costeffectiveness of Rosuvastatin and Atorvastatin in cardiovascular diseases and stroke conditions. Statins being dyslipidemic agents are successfully used as a standard therapy for both primary and secondary prevention of cardiovascular diseases and stroke. METHODS: This pharmacoeconomic study is a cross sectional ambispective study. A total of 300 patients were screened from which 150 are eligeble for primary prevention group and 108 for secondary prevention group. Drug costs, number of events avoided and lipid profiles were recorded, cost effectiveness ratios were determined. Decision tree model was used and statistical comparisions are done using microsoft excel 2007. RESULTS: This study revealed that Rosuvastatin was more effective in preventing reccurence of events i.e., events avoided by Rosuvastatin was 86.37% when compared to Atorvastatin of 64.07%. Rosuvastatin costs an incremental cost of Rs136.5 per lipid profile maintenance and Rs82.82 per event avoided in primary and secondary prevention groups respectively. When calculated in terms of lipid level maintenance Rosuvastatin showed a significant reductions like serum cholesterol(Sr.Ch) of 182.97±30.4mg/dl, High density lipoprotiens(HDL) of 42±2.8mg/dl, Triglycerides(TG) of 148.5±79mg/dl, Low density lipoprotiens (LDL) of 108.9±29mg/dl were as Atorvastatin showed Sr.Ch of 180.26±35.4mg/dl,HDL of 40±15.4mg/dl, TG of 155.8±93.8mg/dl, LDL of 115.4±30mg/dl. CONCLUSIONS: The above results revealed that Rosuvastatin is more cost effective drug inspite of its high unit cost when compared with Atorvastatin. The additional effectiveness gained by Rosuvastatin is worth its additional cost.