Analyse the presence of subclinical atherosclerosis in psoriatic arthritis patients (PsA). A cross-sectional study of 53 patients with PsA and 53 controls matched for age and sex was designed. Carotid intima-media thickness (IMT) and the presence of carotid plaques (CP) were assessed with carotid ultrasound. Data on cardiovascular (CV) risk factors were collected. Patients with PsA had a higher prevalence rate of obesity and tobacco smoking. CP were detected more frequently in patients with PsA than in controls with an OR of 4.15, 95% CI 1.4-12.1, which adjusted for smoking and those with history of CV disease gave an OR of 3.9, 95% CI 1.2-12.7, p = 0.026. Carotid IMT was significantly higher in patients with PsA adjusted for age and tobacco smoking. According to ultrasound data, 30.2% of patients with PsA had carotid atherosclerosis (presence of CP and/or carotid IMT > 0.90 mm) compared with 9.4% of controls. The SCORE index (Systematic Coronary Risk Evaluation) underestimated the CV risk in these patients: most patients with CP had an intermediate CV risk. According to carotid ultrasound data, PsA patients have a high prevalence of subclinical atherosclerosis. These results support the importance of screening for CV risk and to include carotid ultrasound in CV prevention strategies in these patients.