Abstract: Background　The prevalence of dyslipidemia in the Chinese population continues to rise, and it is urgent to improve blood lipid management. However, the poor adherence to statin therapy among patients has emerged as a central challenge in clinical practice. Objective　To deeply explore patients' real-world experiences with long-term statin use from their own perspectives, in order to uncover the complex factors influencing medication adherence and provide insights for improving lipid management practices. Methods　Based on a phenomenological research design, semi-structured in-depth interviews were conducted with 20 patients requiring long-term statin therapy who were managed at a community clinic in Yangfangdian, Beijing, from January to June 2025. The data were analyzed, categorized, and summarized following the core procedures of Colaizzi's phenomenological analysis method. Results　Five core themes influencing statin adherence were identified: misperception of disease risk, profound concerns about medication safety, variability in the implementation of clinical practice guidelines, lack of key information in physician-patient communication and the influence of social and online information environments. Conclusion　A continuous and coordinated healthcare service system should be established as the foundation, with strengthened targeted education for both patients and physicians and enhanced communication skills of medical staff as the core strategies, thereby solidifying trust between patients and healthcare providers. On this basis, efforts should be focused on improving patients' health information literacy to help them develop long-term management beliefs, and ultimately facilitating a fundamental shift from passive medication adherence to active health management.