Evinacumab is a monoclonal antibody designed to inhibit angiopoietin-like 3 (ANGPTL3), a protein that regulates lipid metabolism. By blocking ANGPTL3, it significantly reduces levels of low-density lipoprotein cholesterol (LDL-C), triglycerides, and high-density lipoprotein cholesterol (HDL-C). It is primarily used in the treatment of homozygous familial hypercholesterolemia (HoFH), a rare genetic disorder characterized by extremely high LDL-C levels and increased risk of early cardiovascular disease. Evinacumab is administered intravenously and is particularly effective in patients who do not respond adequately to conventional lipid-lowering therapies such as statins, PCSK9 inhibitors, or ezetimibe. Its mechanism allows for substantial LDL-C reduction independent of the LDL receptor pathway, making it a valuable option for patients with defective or absent LDL receptors. Ongoing research is exploring its potential in other severe dyslipidemias and cardiovascular risk reduction in broader populations.