OBJECTIVES: To understand how Japanese clinicians identify patients with statin intolerance (SI). METHODS: A web-based survey was conducted in Japan between January-February 2014. The survey asked participants to report on how they identify patients with SI. Specialists and general/family physicians (GPs) participated; they were required to have treated ≥75 and 50 patients with hypercholesterolemia, respectively, in the previous 12 months, and ≥5 patients presenting with SI symptoms. Participants provided informed consent. RESULTS: Forty specialists and 20 GPs completed the survey. All symptoms of potential SI were reported at similar frequency by specialists and GPs. Muscle-related symptoms (MRS) were identified by clinicians as the most common symptom (50%), with 42% of patients having elevated creatine kinase (CK) without MRS, and 26% persistent elevation of transaminase. Other symptoms (14%) (e.g. gastric symptoms or alopecia) and CNS effects (1%) were less common at presentation. Rechallenge was the minimum criterion used by 65% of specialists and 50% of GPs to establish whether MRS were due to SI. Clinicians who did not rechallenge (40%) would try either discontinuing the statin (22%) or lowering the dose (12%) to determine whether MRS resolved. Overall, 63% of specialists and 70% of GPs would try ≥2 statins before considering a patient with MRS to have SI. Most clinicians (80%) would recheck known elevation of CK after modifying or discontinuing statin treatment. The majority of respondents (72%) reported they would use additional criteria to establish statin intolerance in patients at high risk of a CV event. CONCLUSIONS: A survey conducted in Japan has shown that the majority of clinicians use rechallenge and alternative statins before considering that a patient with MRS has SI, in accordance with recent global guidance on SI management.