Cardiovascular disease remains the leading cause of global mortality, with elevated LDL cholesterol identified as a key modifiable risk factor. Despite the availability of statins and other lipid lowering therapies, a significant proportion of high risk patients fail to reach guideline recommended LDL-C targets due to variable reasons. With continued research, novel therapeutic approaches targeting the PCSK9 pathway have emerged, most notably Inclisiran, the first approved siRNA based lipid lowering therapy. This thesis was written to review the biology of lipid metabolism and PCSK9, the mechanism of action of Inclisiran via RNA interference and hepatocyte selective delivery, and its clinical efficacy and safety as established through the ORION trial program, with a focus on its positioning relative to existing lipid lowering therapies as a potentially transformative advancement in cardiovascular risk management.