To standardize and harmonize pharmacist-led cholesterol-lowering medication therapy management (MTM) for patients with carotid atherosclerosis and plaque, the Expert Consensus on Lipid-Lowering Pharmacotherapy Management in Patients with Carotid Atherosclerosis and Plaque was developed under the leadership of the PLA General Hospital. This consensus establishes a systematic framework spanning the full-cycle management process: data collection, analytical evaluation, intervention implementation, and long-term follow-up, supported by standardized protocols, documentation forms, and assessment tools. It prioritizes seven evidence-based evaluation domains: therapeutic efficacy, drug selection, dosing appropriateness, adverse reactions, drug-drug/food interactions, cost-effectiveness, and medication adherence. By integrating practical workflows with clinical decision-support tools, the consensus aims to optimize therapeutic outcomes, mitigate safety risks, and provide actionable guidance for healthcare professionals managing this high-risk population.