Abstract Funding Acknowledgements Type of funding sources: None. Introduction Combining statin treatment and physical activity is highly effective to reduce cardiovascular diseases. Statin use may exacerbate statin-associated muscle symptoms (SAMS), making an active lifestyle more difficult for statin users. It is, however, unknown whether daily activity patterns differ between symptomatic and asymptomatic statin users. Purpose To objectively assess physical activity levels and sedentary time and compare these between long-term statin users with or without muscle complaints. Methods Ninety-seven symptomatic (66±9 years, 74% male) and 97 asymptomatic statin users, matched for age and gender in a 1:1 ratio, were recruited from general practitioners offices. Physical activity patterns were measured using the activPAL3 micro monitor, which was attached to the upper right thigh. Participants wore the activity monitor 24 hours per day during 7 consecutive days and were asked to maintain normal daily activities. Results Symptomatic statin users performed less physical activity of moderate to vigorous intensity per day (61.1 min, IQR: 43.1-77.0 min) compared to asymptomatic statin users (69.1 min, IQR: 50.7-94.6 min; P=0.02). There were no differences in physical activity levels of light intensity or sedentary time between the statin groups. Symptomatic statin users took less steps per day (7560 steps, IQR: 5649-9692 steps) compared to asymptomatic statins users (8721 steps, IQR 6306-11791 steps; P=0.02). Conclusion Symptomatic statin users have reduced levels of physical activity compared to asymptomatic statin users. These findings highlight the clinical relevance to explore possibilities for symptomatic statin users to increase physical activity levels and the associated health benefits.