There is a dearth of studies comparing clinical outcomes of different approved starting doses (5, 10 and 20mg) of rosuvastatin in Indian hyperlipidemic patients, in real life clinical settings.In this multi-centre, open-label, non-randomized, parallel group study, 219 Indian hyperlipidemic patients were allocated to therapy with either 5, 10 or 20mg rosuvastatin, based on the judgement by their physicians as a part of routine clinical care. Efficacy and safety assessments were performed at weeks 4 and 8 of therapy. Efficacy endpoints were % change from baseline in low-density lipoprotein cholesterol (LDL-C), total cholesterol, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) and the proportion of patients achieving National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) defined lipid goals.There was statistically significant % reduction in LDL-C, TG, very low-density lipoprotein (VLDL) and total cholesterol values compared to baseline in all three dose groups. A high proportion of patients achieved NCEP defined LDL-C and non-HDL goals for their risk-category. In patients at higher cardiovascular risk, a higher proportion of patients who received 10 and 20mg dose achieved lipid goals at the end of 8 weeks. Rosuvastatin was well tolerated.This study demonstrated the efficacy and safety of rosuvastatin 5, 10 and 20mg starting doses in improving lipid parameters and achieving lipid goals in a heterogeneous group of Indian hyperlipidemic patients in real life clinical practice. In patients with higher cardiovascular risk profile, rosuvastatin 10 and 20mg are more effective starting doses for quicker achievement of NCEP-ATP III-defined lipid goals.