The benefits of statins on prevention of coronary heart disease in women without heart disease have not been clarified. The authors systematically reviewed all the published literature on primary prevention trials and found 6 primary prevention trials to date with sex-specific data on mortality and coronary heart disease events in women. The summary risk ratio for primary prevention of all-cause mortality was 0.90 (95% confidence interval, 0.60-1.35; P=.61) and for any coronary heart disease event was 0.78 (95% confidence interval, 0.64-0.96; P=.02). This review reveals that statin therapy along with diet and exercise in moderately hyperlipidemic women without a previous history of cardiovascular disease is of significant benefit in preventing coronary heart disease events but of no proven benefit in preventing all-cause mortality.