Stroke is the third leading cause of mortality worldwide. Combined carotid intima-media thickness (CIMT) is a marker of atherosclerosis and is also a predictor for ischemic stroke. We determined the frequency of CIMT in patients with acute ischemic stroke and in matched controls and also the risk factors for CIMT. Sixty patients with ischemic stroke diagnosed by computer tomography (CT) scan and 50 controls matched by age, gender, diabetes, and hypertension were studied. Subjects in both groups underwent carotid duplex scanning (ACUSON 128 x P/10 machine) with a 7.5 MHz linear superficial array probe in B-mode to determine the CIMT and presence of plaques. The mean age in the patient group was 62 years and 63.3% were males. The average CIMT in the patient group was 0.798 mm and it was 0.6 mm in the control group (P < 0.0001). Patients with carotid plaque had significantly increased IMT (0.95 +/- 0.22) when compared to patients without plaques (0.71 +/- 0.12) (P < 0.001). When the differences in mean IMT were compared among the different age groups in the patient group, there was significance (P < 0.05). In this study the CIMT was independently associated with increasing age and with the presence of carotid plaques.