BACKGROUND: Common carotid artery intima-media thickness (IMT) is an accepted sonographic marker of early atherosclerosis, and increased IMT represents a risk of ischemic stroke. The purpose of this study was to evaluate the correlation between common carotid artery IMT and stroke risk factors in patients with ischemic stroke. METHODS: Subjects were 381 patients with acute ischemic stroke. High resolution B-mode ultrasonography was performed to measure IMT at common carotid artery. Multivariate regression analysis was performed to determine the independent factors related to common carotid artery IMT. RESULTS: The variables that strongly predicted an increase in the common carotid artery IMT were age (P <0.001) and diabetes mellitus (P <0.001). CONCLUSION: Increased common carotid artery IMT is independently associated with age and diabetes mellitus in patients with ischemic stroke.