At one time atherosclerosis was thought to be an irreversible degenerative disease that was an inevitable consequence of ageing. Research in the past decade has shown that atherosclerosis is neither a degenerative disease nor inevitable. The long-term clinical benefits of reducing LDL-cholesterol, and its impact on decreasing coronary artery disease (CAD) morbidity and mortality, have been conclusively demonstrated. Major statin trials have yielded reductions in the rate of CAD death or non fatal myocardial infarction in both primary as well as secondary prevention, and in patients with mild to moderate as well as severe LDL-cholesterol elevation. However despite the use of high intensity statin therapy often in combination with other available lipid-lowering drugs such as ezetimibe, residual cardiovascular risk remains. New biologics directed against PCSK9 have been shown to be remarkable effective in reducing LDL-cholesterol levels by an additional 50-60%. Biologics against PCSK9, and those under development against ANGPTL3 as well as drugs directed against remnants and Lipoprotein(a) are promising therapeutic class of drugs and may be able to fill the unmet need of residual CAD risk.