Abstract Background and Objectives: Hyperlipidaemia refers to elevated levels of lipids in the blood. Lipids such as cholesterol and triglycerides are insoluble in plasma. Circulating lipid is carried in lipoproteins that transport the lipid to various tissues for energy use, lipid deposition, steroid hormone production, and bile acid formation. To compare the efficacy of Atorvastatin alone with Atorvastatin plus Omega- 3 fatty acids combination in management of hyperlipidaemia. Methods: The study was a comparative, prospective, randomized and open label study. Patients with history of recent MI or post MI, attending the out patients / in patients, Department of General Medicine, DMCH, Darbhanga. Study duration of Two years. Conclusion: The efficacy of combination therapy i.e., Atorvastatin plus Omega-3 fatty acids showed statistically significant rise in HDL cholesterol with mean percentage difference of 3.7% when compared to monotherapy with Atorvastatin.