Background: Because of its high prevalence, subclinical hypothyroidism (SCH) has clinical significance as it is associated with many of the risks of atherosclerotic cardiovascular disease (CVD) due to its direct and indirect effect on lipid profile, diastolic function, and endothelial dysfunction. However, the link between SCH and CVD is still unknown. Objectives: This study aimed to evaluate the carotid intima media thickness (CIMT) and the lipid profile as evidence of endothelial dysfunction and atherosclerosis on patients with SCH. Patients and methods: The current study was a cross-section study carried out on 50 patients with SCH who were enrolled from the Outpatient Clinics of Diabetes and Internal Medicine Department, Assiut University Hospitals, Assiut, Egypt in the period from the 1^st of September 2019 up to the end of December 2021. Also, 50 healthy matched participants who served as control group. All participants underwent full history taking, a thorough clinical examination, and routine lab investigation, in addition to thyroid function tests, lipid profile, echocardiography, and estimation of CIMT. Results: Patients with SCH had significantly higher waist to hip ratio (W/H), higher triglycerides, cholesterol, low-density lipoprotein cholesterol (LDL-c), and increase in CIMT. Seven patients (14%) in the study group had diastolic dysfunction versus no one in the control group. In addition, SCH patients showed that significant positive correlations were founded between CIMT and thyroid-stimulating hormone (TSH), cholesterol and LDL levels. Conclusions: The study found that various cardiovascular risk factors were prevalent in patients with SCH and should be considered.