Statins are a cornerstone of cardiovascular disease prevention. Although generally safe, muscle-related adverse effects remain a concern, as statin-associated muscle symptoms may signal severe conditions such as immune-mediated necrotizing myopathy (IMNM). This case highlights the diagnostic challenge faced by family doctors when common symptoms mask rare but serious disease.A 60-year-old woman with hypertension, type 2 diabetes mellitus, and long-term statin use attended a routine primary care follow-up to discuss recent blood test results. Given her very high cardiovascular risk, the consultation focused on LDL-cholesterol targets, and intensification of statin therapy was agreed. She also reported several months of fatigue and lower back pain. In the context of age and a sedentary lifestyle, these symptoms were initially attributed to degenerative musculoskeletal changes, and physical activity was encouraged with rescue analgesia prescribed. Over subsequent months, her condition deteriorated, with progressive fatigue, unintentional weight loss, and worsening generalized muscle weakness. She quickly became dependent on others for ambulation, personal hygiene, and other daily activities, prompting hospitalization. Diagnostic evaluation, including muscle biopsy, confirmed anti-HMGCR–positive immune-mediated necrotizing myopathy. Despite immunosuppressive therapy, recovery was slow and required three months of intensive physical rehabilitation to regain partial functional independence.While IMNM is described in specialist literature, reports highlighting the primary care perspective remain scarce. This case emphasizes the family doctor’s perspective, where early symptoms may be subtle and nonspecific.Persistent or progressive musculoskeletal complaints in patients receiving statins warrant periodic diagnostic reconsideration. Routine functional assessment and early measurement of muscle enzymes may facilitate earlier diagnosis and reduce preventable disability.Statins are widely prescribed in primary care, and musculoskeletal symptoms are common in the general population. This overlap increases the risk of misattributing early manifestations of rare statin-associated conditions such as IMNM. Continuity of care and longitudinal observation are crucial in identifying when common explanations no longer fit the evolving clinical picture.IMNM is a rare but potentially severe and treatable complication of statin therapy that may initially present in primary care. Early recognition, referral, and access to rehabilitation can significantly impact outcomes, reinforcing the central role of family doctors in person-centred, safe preventive care.