Background: Obesity is a significant public health crisis. Carotid artery Intima-Media Thickness (CIMT) is a new noninvasive ultrasound test that is being recommended to screen for heart disease in apparently healthy individuals. Objective: To determine the relationship between CIMT and obesity in children and adolescents. Patients and Methods: This study was a cross-sectional study, which was done on 74 obese children aged 6-18 years. This study was done at the Pediatrics Department, Zagazig University Hospitals., during the period from 2017 to 2019. All children were subjected to history taking and clinical examination. Anthropometric measurements were measured. Carotid intima-media thickness quantification was estimated. Results: The study resulted in 36 females (48.6%) and 38 males (51.4%). Children lived in rural areas 38(51.4%) and urban areas were 36 (48.6%). There was a significant increase in CIMT in obese children. Statistically significant positive correlations were observed between CIMT and BMI. Statistically significant positive correlations between CIMT and total cholesterol, triglycerides, while no statistically significant correlations were observed between CIMT and LDL, and HDL. Conclusion: There is a relationship between CIMT and obesity in children of the target population of the study and, at the same time, there also exist statistically significant positive correlations between CIMT and total cholesterol, triglycerides, and no statistically significant correlations between CIMT and LDL, and HDL. Regarding the prevalence of insulin resistance (IR) among our studied children, we found that 31 patients were IR (41.9%), while 43 were not (58.1%). Insulin resistance (IR) was statistically higher in children with CIMT > 0.5 millimeters.