Patients with idiopathic inflammatory myopathies (IIM) have an elevated risk of atherosclerotic cardiovascular disease, yet statin therapy may be complicated by muscle-related symptoms and challenges in clinical monitoring. Non-statin therapies offer safe alternatives. Bempedoic acid lowers LDL-cholesterol via liver-specific activation, minimizing myotoxicity while demonstrating cardiovascular benefit in statin-intolerant patients. Ezetimibe provides modest additional LDL-C reduction, and PCSK9 inhibitors achieve potent lipid lowering with favorable safety in small IIM cohorts. These agents enable individualized lipid management when statins are contraindicated or poorly tolerated. Further studies are needed to define optimal lipid-lowering strategies in this high-risk, understudied population.