LDL-cholesterol (LDL-C) reduction after acute coronary syndromes (ACS) is associated with a significant reduction in ischemic recurrences. Accordingly, international guidelines recommend a reduction of LDL-C below 70 mg/dl in ACS patients. Such a result can be accomplished by using high intensity statins, possibly associated with ezetimibe in selected cases. This document outlines the management strategies that can be consistently implemented in clinical practice in order to achieve and maintain guideline-recommended therapeutic goals.