Statins are the main cholesterol-lowering treatments, but often they are stopped because of statin myopathy. Expensive second-line treatments are then prescribed, causing a burden on the health system. Creatine supplementation may be a safe, effective and cheap alternative this shift. We investigated tolerability and possible effectiveness of creatine supplementation in statin myopathy. Our data confirmed previous findings showing that creatine supplementation is safe and well tolerated even in this elder population. In fact, 11 of the 13 enrolled patients completed the study, and only one patient interrupted the study because of a creatine-related issue (elevation of serum creatinine). Creatine supplementation significantly reduced the Shewmon and Craig’s “myopathy score”, while it did not reduce serum creatine kinase (CK), a marker of muscle structural damage. Notably, creatine supplementation was effective at the dose of 1g. t.i.d., lower that usually prescribed in international literature and within the recommendations of health agencies like the Italian Ministry of Health. Thus, creatine supplementation may improve statin myopathy in its milder and/or earlier form, when serum CK is not elevated. Moreover, creatine supplementation may prevent or delay switching from statins to the very expensive second-line anti-cholesterol treatments.