Statins, as one of the commonly used drugs to lower blood lipids, are widely used clinically. It reduces intracellular cholesterol synthesis by competitively inhibiting the endogenous cholesterol synthesis rate-limiting enzyme (HMG-CoA reductase) and blocking the intracellular hydroxymevalonate metabolic pathway. The muscle toxicity of statins has long been of widespread concern as the population of users continues to grow. All types of statins can cause muscle toxicity, with an incidence of about 10-15%. The most common clinical manifestations are muscle pain, proximal symmetric muscle weakness, and rhabdomyolysis. The severity of symptoms is related to the dose and duration of drug use and is also influenced by other co-administered drugs. In patients with statin myopathy, inflammatory cells or increased necrosis and neoplasia can be observed in the muscle pathology, which can be classified as Idiopathic inflammatory myopathy (IIM) or Immune-mediated necrotizing myopathy (IMNM). In 2010, Christopher-Stine L et al [1] first identified an autoantibody in the sera of IMNM patients that reacted to two proteins with molecular weights of 200 kD and 100 kD, respectively, and later the 100 kD molecular weight protein was identified as HMG-CoA reductase, the first autoantibody associated with statin myopathy –The anti-HMG-CoA reductase antibody was unveiled. This antibody is currently detected mainly by ELISA and has a high sensitivity (94%) and specificity (99%), and its titer is related to the blood CK value and the degree of muscle weakness [2]. A 2014 study from Australia [3] tested 207 patients with IIM/IMNM for serum anti-HMG-CoA reductase antibodies and found that 19 positive antibodies were predominantly male and were strongly associated with statin use and HLA-DR11 positivity. Anti-HMG-CoA reductase antibodies are independent of myositis-associated antibodies but, like IIM, may have some association with malignancy. New statin myopathy-associated autoantibodies may soon be identified as studies are conducted. For now, the detection of anti-HMG-CoA reductase antibodies, as well as HLA-DR11, may allow for the assessment of the risk of muscle damage in patients who are about to use, and especially those who require long-term statin use, and thus better prevent the development of statin myopathy.