Familial dyslipidemias are common in the population and correlated with increased risk of cardiovascular disease at young age. The early detection of individuals at high-risk may delay the vascular events and offer an increased quality of life and life expectancy. Screening is recommended in infancy in case of positive family history of premature cardiovascular disease. Lifestyle modifications and eviction of any additive cardiovascular risk are the first step before considering treatment. Statins may be introduced between age 10 to 50 depending on the severity of the familial history, the elevation of the lipid values and the presence of vascular dysfunction.