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Growing evidence suggests that lowering non-high-density lipoprotein cholesterol (non-HDL-C) levels is associated with a reduced risk of cardiovascular diseases (CVD) events. However, data on this relationship remain scarce in the Arabian Gulf region. The Gulf TriglyCeride And ResiduaL CardiovascuLar RiSk (Gulf CALLS) study investigated the association between failure to achieve non-HDL-C targets (<2.6 mmol/L) and residual CVD risk in very high-risk patients from the region who were on statin therapy and had well-controlled low-density lipoprotein cholesterol (LDL-C) levels (<1.8 mmol/L [70 mg/dL]). This retrospective study evaluated patients across 5 Arabian Gulf countries, aged > 45 years with established CVD or diabetes, LDL-C levels <1.8 mmol/L (<70 mg/dL), and triglyceride levels <4.5 mmol/L (<400 mg/dL) on lipid-lowering therapy. A total of 22% (521/2344) of the patients did not achieve the non-HDL-C target. In the adjusted Cox regression model, patients who achieved the non-HDL-C goal at baseline had a 25% lower risk of subsequent CVD events than those who did not (hazard ratio, .75; 95% confidence interval: .58-.97; P = .028). In the present study involving very high-risk patients on statin therapy, failure to achieve non-HDL-C targets was associated with a significantly higher residual CVD risk, despite well-controlled LDL-C levels.