OBJECTIVES: Recent evidence indicates cholesterol reduction to levels below currently recommended goals contribute to further reduction of CHD events. The prescribing pattern of statins and rate of cholesterol goal attainment in CHD patients were evaluated at two public hospitals in Hong Kong. METHODS: Retrospective observational study was conducted at two hospitals (A and B) and 276 patients were randomly selected from the coronary care units. Patients admitted due to acute myocardial infarction (AMI) over the period of January 1, 2001 to December 31, 2002 were followed up. Statin therapy must be prescribed for at least three-months after initial hospitalization. Treatment patterns were determined by studying the dosages, titration (if any), and change of statin therapy. Cholesterol levels were measured before and after treatment and the NCEP ATP III was used to define cholesterol goal (LDL <2.59 mmol/dl). RESULTS: Of the 276 patients, 174 patients (43% female; mean age 63 years [SD 12]) were initiated on statin therapy after admission and studied. Hospital-A had significantly (p<0.05) more patients prescribed simvastatin 40mg or higher dose statins compared to hospital-B. Overall, 48% percent of patients did not experience any change in statin dose, approximately equal number of patients were down titrated (24%) as were up titrated (27%). The cholesterol goal attainment rate based on calculated LDL-C measures using the Friedwald equation was 61.62% at A and 37.70% at B. Based on logistic equation model for goal attainment; patients having hypertension (Odds Ratio [OR] 0.41; 95% CI 0.91 - 0.87), CHD (OR 0.17; 95% CI 0.03-0.93) and elevated LDL-C (OR 0.602; 95% 0.407 – 0.889) at baseline were less likely to attain goal. CONCLUSION: Current lipid lowering therapies fail to bring majority of patients to recommended cholesterol goal at the two hospitals. More effective therapeutic options are needed to help CHD patients attain recommended cholesterol goals.