Background: Diabetes mellitus is accompanied by a substantial increase in the risk of cardiovascular disease. It is also indicated that an increased carotid intima-media thickness (IMT) is related to an increased risk of coronary heart disease and stroke. However, microalbuminuria appears to be a risk marker for atherosclerosis.Aim of The Study: The objective of this study is to estimate the relationship between microalbuminuria and carotid intima-media thickness, as a marker of vascular wall properties, in type 2 diabetic patients.Methods: Subjects were 50 type 2 diabetic patients with normoalbuminuria (N= 27) and microalbuminuria (N= 23). Smokers and those who had clinical evidence of atherosclerotic vascular disease, uncontrolled hypertention, uncontrolled hyperlipideamia or macroalbuminuria were not included. Intima-media thickness of the common carotid artery was measured using high-resolution B-mode ultrasonography.Results: Intima-media thickness was significantly higher in patients with microalbuminuria than in patients with normoalbuminuria (P < 0.001). IMT increased significantly as albuminuria increased in the microalbuminuric range. Age, duration of diabetes and BMI were predictors of both microalbuminuria and IMT. Conclusion: A slight elevation of albuminuria is a significant determinant of IMT independent of conventional cardiovascular risk factors in type 2 diabetic patients with no clinical nephropathy or any vascular diseases. This significant association might point to a link in the pathogenesis of atherosclerosis and diabetic nephropathy.