Objective Cardiovascular disease (CVD) is still the major cause of the morbidity and mortality in uremia patients. The characteristics of major arterial changes, accelerated-atherosclerosis and related risk factors in uremia patients remain unclear. Our study was to evaluate the atherosclerotic damage and its related factors in uremia patients and healthy volunteers. Methods Forty-two uremia patients (male:19 ,female:23) and 41 age and sex matched healthy volunteers (male:20, female:21) were enrolled in this study. Diabetes, smokers, and patients with symptomatic CVD were excluded. The right and left carotid intima-media thickness (CIMT) were measured and plaque structures were studied by B-mode ultrasound. Results The mean CIMT in uremia patients and control group were 0.67 vs 0.13 mm and 0.43 vs 0.05mm, respectively. CIMT was thicker in uremia patients than the healthy subjects (P＜0.001). Age (r=0.39, P＜0.001), mean hematocrit (r=-0.32, P＜0.05), plasma CRP (r=0.52, P＜0.001), ESR (r=0.46,P＜0.01) and albumin (r=-0.37,P＜0.05) levels were significantly associated with the CIMT and plaque presence. Conclusions Our present study suggests that CIMT is thicker in asymptomatic ESRD patients than healthy subjects. We concluded that in addition to various classical risk factors, uremia environment may also contribute to acceleration of the atherosclerotic process.