Background The purpose of this study was to assess the effects of low-dose simvastatin therapy on the plaque regression and vascular remodeling in normocholesterolemic patients. Methods and Results This study included 108 normocholesterolemic patients who underwent intravascular ultrasound study (IVUS)-guided stenting. Patients were divided into two groups according to the simvastatin therapy (simvastatin group; n=62, non-simvastatin group; n=46). 20 mg of simvastatin was taken to simvastatin group. 6-month follow-up quantitative coronary angiography and IVUS data were analyzed at stented and at non-stented segments at 10 mm proximal or distal to the stent edge. At 6-month after stenting, binary in-stent restenosis was present in 18% (11/62) of simvastatin group and in 22% (10/46) of non-simvastatin group (p=NS). In-stent neointima area did not differ significantly between the 2 groups at 6-month follow-up. At non-stented segments, there was no significant difference in plaque volume change between the 2 groups at 6-month follow-up, however, this was compensated by an increase in vessel volume, resulting in an increase in lumen volume in simvastatin group, but not in non-simvastatin group (vessel volume change; 3.2짹0.5 mm3 vs -0.6짹0.3 mm3, p=0.025, lumen volume change; 4.1짹0.7 mm3 vs -2.2짹0.5 mm3, p=0.005). The remodeling index was significantly higher in the simvastatin group compared to non-simvastatin group at 6-month follow-up (1.04짹0.45 vs 0.97짹0.37, p=0.015). Conclusion In normocholesterolemic patients undergoing coronary stenting, low-dose simvastatin therapy does not inhibit intimal hyperplasia at stented segments, but it induces positive vascular remodeling without significant plaque regression at non-stented vascular segments containing atherosclerotic plaques.