Epilepsy is one of the neurological disorders that quite common, which about 50 million people worldwide affected each year. Most of the epilepsy patients need longterm therapy, and old-generation of antiepileptic is often used as monotherapy. Long-term usage of antiepileptic drugs plays an important role in the pathogenesis of atherosclerosis. The incidence of atherosclerosis can be estimated by the thickness of tunica intima-media carotid artery. This study aimed to evaluate the correlation between long-term usage of old-generation antiepileptic drugs and the carotid intima-media thickness. We conducted a cross-sectional study in DR. M. Djamil Hospital, Padang, between March until August 2018. A total of 26 epilepsy patients were recruited. Those with the cardiovascular risk factor, the subject who did not undergo treatment regulary were excluded. The carotid intima-media thickness was measured by EPIQ7 Ultrasound systems Machine. The relationship between variables was analyzed using Kendall's tau test b, and p-value <0.05 was considered to be statistically significant. Most subjects received phenytoin as their regular AED (76.92%), while 4 subjects received Carbamazepine (15.38%) and 1 subject received phenobarbital (3.84%), and the other drugs (3.84%). The mean duration of therapy was 2.88 years. There is no correlation between long-term usage of AEDs and carotid intima-media thickness in epileptic patients (p=0.052). There was no significant correlation between long-term old-generation usage of antiepileptic drug and carotid intima-media thickness.