The long-term efficacy of statins for the primary and secondary prevention of coronary heart disease is well established; however, until recently, there was little trial-based evidence to support the early clinical benefit of these agents after acute coronary syndromes (ACS). This is particularly important as ACS is characterised by a high rate of recurrent early events in the first 6 months and (traditionally) lipid-lowering therapy was perceived to reduce coronary heart disease risk by lowering the significant risk of elevated cholesterol over many years. This paper reviews the current state of evidence from the key statin trials in ACS and their implications for the future management of ACS.