Dyslipidemia represents one of the major risk factors for atherosclerosis affecting the arteries of large and medium caliber and consequently causing ischemia in the brain, heart, or legs. Coronary artery disease and cerebral stroke represent the major causes of morbidity and mortality among the elderly and middle aged subjects. The change of lifestyle can reduce the risk of cardiovascular disease but available drug therapy (in particular statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase) is effective in modifying hyperlipidemia and consequently reducing cardiovascular events. The hypolipemic drugs can prevent, slow the progression and sometimes determine the regression of atherosclerotic plaques, therefore significantly reducing the clinical complications of atherosclerotic cardiovascular disease. In this review, we want to point out the role of the different lipoproteins, such as triglycerides, HDL-C, LDLC, Lp(a), in the pathogenesis of stroke and the role of statins in reducing both lipid fractions and stroke risk.