In the present study the association was evaluated between non-invasively assessed atherosclerosis of the abdominal aorta and ultrasonographically measured intima-media wall thickness of the common carotid arteries in a population-based study of 41 elderly women. Atherosclerosis of the abdominal aorta was assessed in 1985 using a lateral X-ray of the lumbar spine, on which the presence of calcified deposits was determined. The carotid arteries were ultrasonographically evaluated in 1990 for presence of atherosclerotic plaques and intima-media wall thickness of the distal common carotid was measured off line using dedicated software. The age-adjusted mean intima-media wall thickness of the right common carotid artery was significantly higher in subjects with calcified deposits in the aorta (n = 16) compared with those without deposits (n = 25) with a mean difference of 0.15 mm (95% confidence interval (CI) 0.03,0.26). For the left side similar results were observed. Mean common carotid intima-media wall thickness, ((left + right)/2), differed significantly across groups with a mean difference of 0.11 mm (95% CI 0.01,021). Additional adjustment for differences across groups in body mass index, serum cholesterol, hypertension and smoking did not change the magnitude of the observed association: mean difference of 0.12 mm (95% CI -0.01,0.25). The findings of the present study provide evidence that among subjects with atherosclerotic plaques in the abdominal aorta, the intima-media wall thickness of the distal common carotid arteries is increased.