The purpose of this paper was to assess whether statins reduce all-cause mortality and cardiovascular (CV) events in elderly people without established CV disease. Because of population aging, prevention of CV disease in the elderly is relevant. In elderly patients with previous CV events, the use of statins is recommended by guidelines, whereas the benefits of these drugs in elderly subjects without previous CV events are still debated. Randomized trials comparing statins versus placebo and reporting all-cause and CV mortality, myocardial infarction (MI), stroke, and new cancer onset in elderly subjects (age ≥ 65 years) without established CV disease were included. Eight trials enrolling 24,674 subjects (42.7% females; mean age 73.0 ± 2.9 years; mean follow up 3.5 ± 1.5 years) were included in analyses. Statins, compared with placebo, significantly reduced the risk of MI by 39.4% (relative risk RR: 0.606 95% confidence interval (CI): 0.434 to 0.847; p = 0.003) and the risk of stroke by 23.8% (RR: 0.762 95% CI: 0.626 to 0.926; p = 0.006). In contrast, the risk of all-cause death (RR: 0.941 95% CI: 0.856 to 1.035; p = 0.210) and of CV death (RR: 0.907 95% CI: 0.686 to 1.199; p = 0.493) were not significantly reduced. New cancer onset did not differ between statin- and placebo-treated subjects (RR: 0.989 95% CI: 0.851 to 1.151; p = 0.890). In elderly subjects at high CV risk without established CV disease, statins significantly reduce the incidence of MI and stroke, but do not significantly prolong survival in the short-term.