Cardiovascular disease (CVD) is the leading cause of death in the United States, and certain population groups, such as South Asians, African Americans, and Hispanics, carry a disproportionately larger burden of CVD manifested as coronary artery disease, cerebrovascular disease, and hypertension. Persons of these special populations experience approximately two- to threefold greater morbidity and mortality. Prevalence of risk factors, including dyslipidemia, overweight, and diabetes, is not only higher in these groups, but is also rising. The reasons for such disparity appear to be multifactorial and influenced by such factors as lifestyle, diet, culture, genetics, and suboptimal healthcare. Furthermore, because these minority populations are not significantly represented in major clinical trials, evidence-based management strategies for treatment and prevention of CVD are seriously lacking. Lately, however, several randomized trials of therapy for dyslipidemia to reduce cardiovascular events among these ethnic groups have been undertaken. Preliminary data suggest the need for stricter goals and increasingly aggressive therapy for these special populations, including administrative and educational interventions.