Experts' guidelines for the management of dyslipidemias differ from country to country, with important differences between medical societies of Europe and the United States. Recently, new American and European guidelines have been established. These guidelines mainly differ for cardiovascular risk stratification in secondary prevention, and for LDL-cholesterol (LDL-c) goals to achieve. Similitudes between guidelines include the global strategy to initiate lipid-lowering drugs, which is based first on the global cardiovascular risk, then on the LDL-c level. We are here presenting a comparison and an interpretation of these guidelines.