BACKGROUNDObesity is increasing at a rapid pace in developing countries because of life style transition. Carotid intima media thickness is a marker of coronary heart disease in adults.Aim of this study is to find out the correlation of carotid intima media thickness with the usual measures of childhood obesity like waist circumference, waist-hip ratio and also with abdominal fat indices and lipid profile MATERIALS AND METHODS 75 obese children and 50 age and sex matched controls between 5-12 years attending Paediatric Endocrinology Clinic in Government Medical College, Kozhikode, Kerala were included. Abdominal fat thickness and fatty liver were measured by abdominal ultrasound and intima media thickness of both carotid arteries were measured at 2 cm before the bifurcation of common carotid artery. Statistical analysis was performed by using SPSS version 18. RESULTSAbdominal fat indices and carotid intima media thickness were higher in obese children compared to controls. Carotid intima media thickness had positive correlation with waist circumference, abdominal fat indices, systolic pressure, fasting blood sugar and total cholesterol in obese children CONCLUSION Carotid intima media thickness is a definitive screening method for evaluating cardiovascular risk in obese children.