A nested case–control study of male patients with Barrett oesophagus, who were identified from national Veteran Affairs outpatient files, was analysed for the effect of statin use on the development of oesophageal adenocarcinoma (OAC). A cohort of 856 patients with Barrett oesophagus only (controls) were compared with 311 patients with Barrett oesophagus and subsequent OAC. A substantially lower percentage of patients with OAC used statins for 6–18 months (10.0% versus 17.1% controls) and >18 months (19.3% versus 24.0% controls). Statin use was inversely associated with OAC development (OR 0.65; 95% CI 0.47–0.91) and the protective influence was most notable against advanced-stage OAC and increased with statin dose.