<p>Hyperlipidemia, characterized by elevated cholesterol and triglyceride levels, is a major risk factor for cardiovascular diseases, metabolic disorders, and obesity. Although conventional lipid-lowering therapies such as statins and fibrates are widely used, their adverse effects necessitate the exploration of safer, natural alternatives. Coumarins, a diverse class of benzopyrone derivatives, have gained significant attention for their broad pharmacological properties, including their potential role in regulating lipid metabolism. This review consolidates current knowledge on the anti-hyperlipidemic properties of coumarins, focusing on their molecular mechanisms, therapeutic potential, and synergistic interactions with conventional drugs. An extensive analysis of preclinical studies, clinical trials, and mechanistic investigations was conducted to evaluate the lipid-lowering effects of coumarins and their derivatives. Coumarins exhibit potent anti-hyperlipidemic activity through multiple mechanisms, including modulation of lipid-related gene expression, inhibition of key enzymes such as HMGCR reductase and fatty acid synthase, and regulation of transcription factors like SREBP and PPAR-γ. Both in vitro and in vivo studies demonstrate significant improvements in lipid profiles, including reductions in TC, LDL, and triglycerides, alongside increases in HDL levels. Additionally, coumarins enhance the efficacy of statins and other dietary components, suggesting synergistic therapeutic benefits. Coumarins represent promising natural agents for managing hyperlipidemia and associated disorders. Future research should focus on optimizing their bioavailability, elucidating precise molecular targets, and evaluating long-term safety to facilitate their clinical translation.</p> Graphical Abstract <p></p>