Patients admitted to an intensive care unit after vascular and cardiothoracic surgery are at very high risk of postoperative cardiac morbidity and mortality. Increasing evidence shows that statins should be prescribed to high risk surgical patients in the perioperative period, and that statin therapy should not be withheld in the postoperative period. Because of their pleiotropic effects, the indication for statin therapy has expanded to other patient categories often admitted to an intensive care unit. There is increasing discussion of a potential role for statins in the management of severe infections, sepsis and renal failure. Therefore statin therapy may be the next logical step in the search for adjuvant therapy in diseases commonly seen on the intensive care unit. Copyright © 2011, Nederlandse Vereniging voor Intensive Care.