In our article, we aimed to identify whether there is an increase in intima-media thickness (IMT) measured from the abdominal aorta in patients with acromegaly and to identify the parameters closely related to the aortic IMT (AIMT). Materials and Methods: 52 patients with acromegaly and 46 healthy controls were included. For all participants, all the necessary laboratory tests were done for acromegaly. On vascular ultrasound examination, the internal carotid IMT, common-carotid IMT, and aortic IMT (AIMT) were measured. The study population was divided into 3 different groups; control group (Group I), acromegaly patients in remission (Group II) and acromegaly patients with active disease (group-III). Results: The incidence of hypertension, diabetes, and smoking was higher in Group-II-III than Group I. Insulin-like growth factor-1 (IGF-1) levels were increased from Group I to III and there was a significant difference between all groups. Common-carotid IMT and internal carotid IMT values were not significantly different between the groups. The AIMT value in Group III patients was statistically higher than the other two groups. The AIMT was similar between Groups I to II. Only the IGF-1 level was found to be independently associated with AIMT. Conclusion: In patients with active acromegaly disease, AIMT is significantly elevated without elevation of carotid IMT, and AIMT is independently associated with serum IGF-1 levels. AIMT could be a useful study to show the presence of early subclinical atherosclerosis in acromegaly patients.