Familial dyslipidaemia is a significant cause of premature cardiovascular disease but remains frequently underdiagnosed in general practice. The principles of family medicine, including continuity, holistic care, and attention to family systems, create favourable conditions for early recognition of hereditary lipid disorders. Understanding family structures, shared behaviours, and intergenerational patterns enhances risk identification. The genogram, in particular, offers an efficient visual tool to map biological relationships and highlight patterns suggestive of inherited dyslipidaemia.This literature review aimed to explore how familial dyslipidaemia is addressed within general practice consultations and to assess the value of structured family history and genogram-based assessment in improving case recognition, risk stratification, and follow-up. A secondary objective was to identify barriers and facilitators influencing the implementation of family-centred approaches in routine primary care.A narrative literature review was conducted using PubMed, Embase, Scopus, and Web of Science. Search terms included “familial dyslipidemia,” “familial hypercholesterolemia,” “primary care,” “family medicine,” “general practice,” and “genogram.” Articles published in English between 2000 and 2024 were screened. Inclusion criteria were studies addressing diagnostic strategies, family assessment tools, or management of familial dyslipidaemia in primary care. Exclusion criteria were studies conducted exclusively in specialist settings or lacking relevance to family-oriented approaches. Thematic synthesis was used to summarise key findings.Evidence indicates that familial dyslipidaemia remains under-recognised in general practice, with diagnostic gaps often exceeding 70%. Structured family history-taking improves identification of index cases, and genogram use supports recognition of multigenerational patterns consistent with inherited lipid disorders. Family-based counselling increases screening uptake and promotes lifestyle adherence among at-risk relatives. Reported barriers include time limitations, insufficient training in genogram use, inconsistent documentation, and a lack of electronic integration. Facilitators include longitudinal patient relationships and team-based care.The findings suggest that family-centred assessment strengthens preventive cardiovascular care by linking clinical information with hereditary risk patterns. The genogram is useful but remains underused due to practical constraints.Incorporating systematic family assessment and genogram use can improve the detection and management of familial dyslipidaemia in general practice. Further research should examine the impact of genogram-guided approaches on diagnostic accuracy and long-term cardiovascular outcomes.