Hypercholesterolemia occurs when there is too much cholesterol in the blood. It is not a disease as such but a metabolic derangement. Elevated cholesterol in the blood is due to an increase in the amount of the so-called lipoproteins, particles that carry cholesterol in the bloodstream. There are two major types of cholesterol: HDL (high-density lipoprotein) cholesterol and LDL (low-density lipoprotein) cholesterol. Hypercholesterolemia usually means elevated levels of total blood cholesterol or LDL-cholesterol with normal or low levels of HDL-cholesterol. People with hypercholesterolemia have a higher risk of developing coronary artery disease, heart attacks, and stroke. Chinese herbal medicines have been commonly used and studied as cholesterol-lowering agents. To evaluate the effects of various herbal formulations (including single herbs, Chinese proprietary medicines, and mixtures of different herbs) for treating hypercholesterolemia, this review examined 22 randomized controlled trials of five different Chinese herbal medicines. The trials lasted from one to six months (average 2.3 months) and involved 2130 participants. There were no data on cardiovascular events and death from any cause. One trial each reported on well-being (no significant differences) and economic costs . No serious adverse events were observed. The available evidence suggests that several herbal medicines showed some cholesterol-lowering effect. However, due to considerable limitations in the quality of the included trials, further higher-quality and rigorously performed studies are required before any confident conclusions can be reached about the effects of Chinese herbal medicines for hypercholesterolemia.