This review discuss the possible 10 top reasons why cardiologists are/should be interested in lipids. 1. Epidemiologic evidence. Blood lipid levels are risk factors for coronary heart disease and predict subsequent mortality in the patients seen by cardiologists. 2. Lipids play a major physiopathologic role in ischemic heart disease. Stenosis of the coronary arteries are produced by atherosclerotic plaques, composed of a mass of lipids covered by a fibrous cap. Plaques with increased lipid content appear more prone to rupture and cause acute coronary syndromes. 3. Lipid abnormalities are very common in patients with ischemic heart disease. At least half the patients with angiographic evidence of significant coronary artery narrowings have severe abnormalities of lipids that are easy (and cheap) to detect. 4. Reduction of cholesterol is associated with regression of atherosclerosis, as has been demonstrated by angiography in patients with coronary heart disease. 5. Reduction of cholesterol is associated with reduction of symptoms and ischemic events. 6. The most striking benefit of lipid lowering therapy is shown in patients, already with evidence of ischemic heart disease. 7. The new lipid lowering agents present a new profile of actions and may improve symptoms in the short term. 8. There is still controversy about who should be treated, when and with what drugs, and this questions will be solved with the evidence of large, multicenter, well designed trials that are now in progress. Cardiologists must contribute to this studies, know and discuss the results. 9. If a patient is not given by his cardiologist any drug to reduce the cholesterol it is quite improbable that other doctor would make such recommendation. 10. Even if the cardiologist is not interested in lipids their patients are, and seek and deserve advice.