Introduction: Given the substantially increasing geriatric population, the need for evidence-based strategies to address the medical and societal consequences of these demographic trends has never been greater. In this context, statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) provide substantial potential social value by improving health and survival. However, using statins for primary prevention in older adults presents a clinical dilemma. Even though compelling evidence exists supporting statins for secondary prevention in individuals older than 75 years with clinical ASCVD, the same cannot be said for primary prevention. In this Viewpoint, we describe existing evidence on the benefits of statins for primary prevention in older adults, uncertainties about risks, and the need for a randomized trial before non–evidence-based prescribing patterns become irreversibly incorporated into practice.