Introduction: Familial hypercholesterolemia (FH) is a common genetic disease of high levels of cholesterol leading to premature atherosclerosis. Attainment of LDL-goals with lipid-lowering is the mainstay of treatment for prevention of premature cardiovascular events. Study was conducted to provide insight to the clinical status of FH pts in real clinical setting.Hypothesis: FH patients are undertreated even in specialized centers.Methods: A-HIT2 is a registry of adult FH pts admitting to outpatient clinics. Pts were recruited from 30 outpatient clinics representing 12 Nuts statistical Regions in Turkey. Primary objective of this cross-sectional study, was to detect the clinical status and management of pts diagnosed with FH in Turkey. Patients with a total score of > 2 according to DLCN criteria were accepted as possible FH.Results: 684 FH pts (mean age: 54±10 years, 57% women) were enrolled from sites specialized on cardiology, internal medicine, and endocrinology. Mean DLCN score was: 6.37±4.09. At the time of enrollment, mean LDL-cholesterol level was 218±74 (54-914) mg/dL. Mean age at the diagnosis was: 47±14 years. Overall, coronary artery disease was documented in 38% of cases. Age at the first CV event was 50±10 years. 43.3% was on statin treatment (of 48% atorvastatin and 47% rosuvastatin). Only 185 pts were receiving intensive dose of statins. LDL- goal attainment rate was only 8% in pts receiving statins. Most of the pts were not receiving proper doses of statins.Conclusions: FH is still undertreated in Turkey even in specialized centers.