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This medication use evaluation examined areas for improvement in lipid management of 372 patients hospitalized with non-ST elevation ACS and ST elevation ACS at Cape Fear Valley Medical Center from October 2020-2021. The primary outcome assessed percentage of patients appropriately receiving high intensity statin therapy at discharge. Analysis revealed 325 patients (87.3%) were discharged on a high intensity statin, but 123 (37.8%) were eligible for additional therapy with ezetimibe and/or a PCSK9 inhibitor to reach goal LDL. This evaluation highlights a need for greater emphasis on therapeutic optimization, improved provider education, and orderset adjustments to ensure appropriate lipid monitoring post-ACS.