Inflammation is a predictor of cardiovascular disease (CVD). Thus, inflammatory bowel diseases (IBD) may be associated with CVD. We assessed carotid intima-media thickness (cIMT; an indicator of CVD risk) in 42 patients with IBD, free of CVD or diabetes; 26 with Crohn's disease (CD) and 16 with ulcerative colitis (UC). The cIMT was significantly greater in patients with IBD compared to 42 healthy controls (0.62 ± 0.08 vs 0.52 ± 0.06 mm; P < .0005). The cIMT did not differ between patients with CD and UC or between the different disease activity and treatment groups. Factors associated with cIMT were age, body mass index, and IBD, with the latter making a greater contribution. The IBD is a predictor of cIMT, even when other CVD risk factors are considered. These findings suggest an association between early arterial wall alterations and IBD. Such an association should be proven in larger studies that should assess the incidence of CVD in patients with IBD.