Statin intolerance, though uncommon, presents a challenge for patients who experience persistent side effects despite adjustments in dosing or switching statins. Dr. Matthew Sorrentino reviews evidence-baesd alternatives, shares insights on practical use in clinical care, and highlights the latest advances in lipoprotein (a)–targeted therapies now in late-stage development. Dr. Sorrentino is a Professor of Medicine and Vice Chair for Clinical Operations in the Section of Cardiology at University of Chicago Medicine.