The aim of this study was to investigate the iron concentrations in serum and carotid plaque in patients with different morphology of carotid atherosclerotic plaque and compared with other metal ions. Carotid endarterectomy due to the significant atherosclerotic stenosis was performed in 91 patients. Control group consisted of 27 patients, without carotid atherosclerosis. Atherosclerotic plaques were divided into four morphological groups, according to ultrasonic and intraoperative characteristics. Iron, copper and zinc concentration in plaque, carotid artery and serum were measured by spectrophotometry. Serum iron concentrations were higher in patients with hemorrhagic plaques in comparison to the control group (4.7 μmol/l ± 1.2 vs. 2.1 μmol/l ± 0.8, p < 0.05). Iron concentrations were higher in patients with hemorrhagic plaques in comparison to fibrolipid plaques (72.1 ± 14.3 μg/g vs. 39.3 ± 22.9 μg/g; p < 0.05). Negative significant correlation was found for zinc in serum and plaque iron concentration in patients (p < 0.05). We also demonstrated positive significant correlation for copper and iron in serum (p < 0.05). The data obtained in the current study are consistent with the hypothesis that high iron levels may contribute to atherosclerosis and its complications as factors in a multifactorial disease.Keywords: carotid plaque, atherosclerosis, iron, zinc, copperOver the last 30 years, several studies in animals and humans assessed the effect of increased body iron levels on atherosclerosis, yielding conflicting results.Iron is a key element in many biochemical processes and shortage of iron causes damage to cells and organs. On the other hand, excess iron could be harmful because it is able to catalyse the formation of highly reactive oxygen and hydrogen radicals when present in the unbound state. Transition metal ions, established catalysts of protein, lipid and DNA oxidation, are present at elevated levels in human atherosclerotic plaques, and in some animal models, consistent with the hypothesis that metal ions contribute to both plaque formation and its destabilization (19,21,23), though the role of metal ions remains controversial (16,29).Epidemiological studies have reported an increased incidence of cardiovascular disease (CVD) in subjects with overt iron overload (7,8,19). Recent studies on cardiovascular evaluation and outcome in high-versus low-frequency blood donors have demonstrated improvements in surrogate markers of vascular health such as decreased oxidative stress, and