OBJECTIVES: UK General Medical Services Quality Outcomes Framework (QOF) set £5mmol/L total cholesterol (TC) as an audit standard for diabetes. European and British expert guidelines recommend lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) targets. This observational study reviewed rosuvastatin in UK general practice. METHODS: Surveys of rosuvastatin 10mg (R10) in routine general practice were provided as a medical service by AstraZeneca from 2004. Permission to analyse anonymised data was granted by 101/150 practices that participated before 2006. Analyses of patients with diabetes achieving TC QOF target £5 mmol/L, Joint European Societies (JES) targets TC<4.5 mmol/L and LDL-C<2.5 mmol/L, and Joint British Society (JBS2) Targets TC<4mmol/L and <2mmol/L, pre and on R10 were conducted. RESULTS: TC test results were available prior to and on R10 for 2868 patients on practice diabetes registers (1726 patients statin naïve, 1142 switched from another statin). Statins commonly prescribed were simvastatin and atorvastatin. When comparing results prior to and on R10 the following were observed: TC reduction -‘all' (28%) ‘new' (32%) ‘switch' (19%) groups (p<0.001); LDL-C reduction -‘all' (39%) ‘new' (45%) ‘switch' (28%) groups (p<0.001). A greater proportion on R10 compared to prior treatment achieved: QOF target TC £5mmol/L - ‘all' (24%: 85%), ‘new' (14%: 86%), ‘switch' groups (38%: 83%) (all p<0.0001); JES target TC £4.5mmol/L - ‘all' (15%: 71%), ‘new' (8%: 46%), ‘switch' (26%: 65% groups and LDL-C goal <2.5mmol/L - ‘all' (24%: 79%), ‘new' (12%: 80%), ‘switch' (41%: 78%) groups (p<0.0001); JBS2 goal TC<4 mmol/L - ‘all' (7%: 51%), ‘new' (4%: 56%), ‘switch' (13%: 43%) groups and LDL-C goal <2mmol/L - ‘all' (11%: 59%), ‘new' (5%: 61%), ‘switch' (19%: 55%) groups (p<0.0001). CONCLUSION: Use of rosuvastatin 10mg in general practice across UK helped greater proportions of patients with diabetes reach QOF, European and British targets.