Hypercholesterolemia, or elevated levels of LDL fraction cholesterol, is one of the major cardiovascular (CV) risk factors. For this lipid metabolism disorder, pharmacotherapy is used in addition to the use of non-pharmacological methods (performing regular aerobic physical activity, eating a diet low in saturated fat, maintaining body weight at normal levels, not smoking tobacco products). The 2021 European Society of Cardiology expert guideline on CV prevention proposes a hypolipemic treatment pathway that should be followed when treating patients with hypercholesterolemia. Treatment usually begins with the inclusion of a potent HMG-CoA reductase inhibitor (statin). If treatment with a statin alone is insufficient to achieve the intended therapeutic effect, a drug that works by another mechanism is added to the therapy: ezetimibe or one of the PCSK9 inhibitors. If a combination of statin and ezetimibe is used, combination formulations containing 2 active substances in one tablet can be used. This paper discusses the management of hypercholesterolemia therapy in daily clinical practice, depending on the CV risk of patients.