In March 2026, the American College of Cardiology (ACC), the American Heart Association (AHA) and other professional societies released the "Guideline on the Management of Dyslipidemia". Building on the 2018 "Guideline on the Management of Blood Cholesterol", the new guideline incorporates recent evidence from large-scale randomized cardiovascular outcome trials and contemporary risk-prediction studies. It broadens the focus of lipid management from cholesterol-centered treatment to a comprehensive, life-course management of atherogenic lipoprotein risk. For patients undergoing cardiovascular surgery, the guideline is pertinent not only for perioperative risk stratification and postoperative secondary prevention, but also offers a more sophisticated framework for long-term comprehensive management. In this article, combined with clinical guidelines and key evidence-based evidence, we interpret the major updates of the 2026 edition of the guideline and implications for cardiovascular surgical practice, with the aim of providing a reference for perioperative and long-term blood lipid management for cardiovascular surgery patients.