Hyperlipidaemia, as a primary atherogenic risk factor, represents a major problem of public health. This review first reminds the main steps of lipoprotein metabolism, the classification of the most frequent hyperlipidaemias, the objectives of the treatment and the required initial evaluation allowing to decide how to manage the patient. Thereafter, it describes all the available treatments, more particularly the characteristics of the various lipid lowering drugs. Finally, it proposes a step by step strategy for the treatment of the main hyperlipidaemias and summarizes the managements of some particular cases.