Background: Bronchial asthma is commonly associated with systemic complications that contribute to its burden including cardiovascular diseases, in which atherosclerosis is the leading histopathologic ground.  Objective: To study the coexistence of atherosclerosis in bronchial asthma patients and to identify clinical characteristics and risk factors related to it in asthmatic patients. Methodology: A case-control study that included 100 bronchial asthma patients and 100 non-asthmatic apparently healthy subjects were performed. All participants were subjected to the measurement of spirometric-indices, blood eosinophils, lipid profile, serum total IgE, and carotid duplex ultrasonography. Results: There was a significant increase in eosinophil count, total IgE, cholesterol, low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) with a significant decrease in high-density lipoprotein (HDL) in the asthma group than in controls. Dyslipidemia was significantly more common in the asthma group than in controls (44% vs. 10% respectively, p< 0.05). There was a significant increase of both common carotid arteries intima-media thickness (CCAs IMT) with a significant higher frequency of atherosclerosis in asthmatic patients than in controls (26% vs. 6% respectively p< 0.05).  In the asthma group, both CCAs IMT were positively correlated with age, BMI, asthma duration, total cholesterol (TC), triglycerides (TG), LDL, eosinophils count, and total IgE, while they were negatively correlated with the age of asthma onset, spirometric-indices, and HDL. The significant risk factors of atherosclerosis in asthmatic patients were higher LDL (OR 7.160), family history of allergic diseases (OR 5.512), poor asthma control (OR 4.318), higher eosinophils (OR 4.110), higher IgE (OR 4.066), younger age of asthma onset (OR 2.768), higher BMI (OR 2.418), lower spirometric-indices (OR >2), longer asthma duration (OR 1.704), and higher patient age (OR 1.212). On the contrary, HDL demonstrates protective effect (OR 0.071). Conclusion: This study declares an association between asthma and atherosclerosis, in particular uncontrolled severe persistent asthma. The most impressive risk factors of atherosclerosis in asthmatics include dyslipidemia, lower spirometric-indices, higher eosinophils and total IgE levels.