Cardiovascular diseases (CVDs) remain the leading cause of mortality in the Republic of Moldova, accounting for over 55% of deaths from non-communicable diseases. Dyslipidemia is a significant modifiable risk factor for CVD, and statins, particularly rosuvastatin, are among the most effective lipid-lowering agents. However, inter-individual variability in statin response, including the risk of adverse reactions such as myopathy, has been linked to genetic factors. This study hypothesized that the frequency of the rs4149056 polymorphism of the SLCO1B1 gene in the Moldovan population would be similar to that of other European populations, given geographic and ethnic proximity, with implications for statin therapy optimization. The rs4149056 polymorphism encodes a Val174Ala substitution in the OATP1B1 hepatic transporter, altering statin pharmacokinetics. We genotyped 431 healthy Moldovan individuals aged 18–29 using TaqMan® SNP Genotyping Assays. The minor C allele had a prevalence of 20.8%, comparable to other European cohorts. Homozygous CC genotypes, associated with a high risk of statin-induced myopathy, were present in 3.5% of the study population. These findings emphasize the clinical relevance of pharmacogenetic screening for SLCO1B1 variants to guide statin therapy in Moldova. Implementing such screening in clinical practice may reduce the incidence of adverse reactions and improve lipid-lowering treatment outcomes. Our results represent the first data on SLCO1B1 pharmacogenetic variability in Moldova and support the growing field of personalized cardiovascular pharmacotherapy in Eastern Europe.