OBJECTIVES: Little is known about statin utilization pattern in Thailand. This study aims to determine its usage pattern and evaluate whether the high-potency statin is needed in patients receiving them. METHODS: This retrospective cohort included patients receiving statin as the first time in year 2005 at a large tertiary care hospital in Thailand. Using electronic medical records, its indication was determined based on history of coronary heart diseases. The lipid profiles tested within 30 days prior to the first date of statins prescription were analyzed. Each patient was assessed whether statin is needed and the lipid goal can be achieved by a less potency statin. Descriptive statistics were used in the analysis using STATA software. RESULTS:  A total of 2479 first time statin users were included. Patients were 56.64% female, their mean age was 60.26 years. Ninety percent of the users received simvastatin, while 8% and 2% received atorvastatin and pravastatin respectively. More than half (58.04%) was used for primary prevention. In patients receiving statin for primary prevention purpose, about half of statin users does not need it. All usage of atorvastatin was considered not needed. In patients using statin for secondary prevention purpose, more than 80% of atorvastatin users should be switched to simvastatin. Only 8% of simvastatin usage would not be able to achieve the LDL goal.  When the LDL goal is less than 70 mg/dL, patients are likely to require high potency statin. Among simvastatin users, 40.17% is considered appropriate, while 58.59% need atorvastatin to be prescribed.CONCLUSIONS:  This study revealed that atorvastin use is mostly not needed except patients using statins for secondary prevention, with LDL goal less than 70 mg/dL. Our findings prompts hospital policy makers to develop measures to ensure apprpriate use of statins in their clinical settings.