Background: In the last few decades there is substantial improvement in atherosclerotic cardiovascular disease (ASCVD) outcomes; however ASCVD remains the leading cause of morbidity and mortality globally. In the past 20 years, statin medications have emerged as safe and highly effective medications for ASCVD primary prevention among essentially all groups at higher risk for ASCVD. International guidelines provide a clear recommendation for the use of statin therapy as one of the core prevention strategies of cardiovascular disease however, the implementation of this recommendation in routine clinical practice is not well known in Ethiopia.