In recent times, there has been a surge in proposed alternative approaches to computing low-density lipoprotein cholesterol (LDL-C), with a focus on enhancing precision, particularly within diverse demographic and clinical groups. Our aim is to assess the agreement, precision, and practicality of these methods compared to direct LDL-C measurements, with the goal of identifying the most effective approach for estimating LDL-C in the Indian context. It is a retrospective analytical study. Lipid profile data were gathered from the laboratory and organized in Microsoft Excel for analysis. LDL-C was computed using three different methods: the Friedwald formula, the Martin-Hopkins formula, and Sampson's formula. These calculations were then compared with the direct method of LDL-C estimation in two distinct groups: when triglyceride (TG) levels were less than 400 mg/dL and when TG levels exceeded 400 mg/dL. Bland-Altman plots were generated, and concordance correlation coefficients (CCCs) were computed to determine the most suitable calculated method. Data from 1,776 participants were analysed and divided into two groups. In both Group 1 (TG < 400 mg/dL) and Group 2 (TG > 400 mg/dL) considering bias, limits of agreements, and correlation coefficient, as seen on the Bland-Altman and CCC, Martin-Hopkins equation was found to be performing better than Friedwald and Sampson's equation. In this study, the Martin-Hopkins formula appears to be the most appropriate choice for precise LDL-C level measurements and indicated improved accuracy and consistency in LDL-C measurements, especially in individuals with elevated TG levels. This underscores its importance in ensuring precise assessment and suitable clinical management.