Cardiovascular diseases (CVD) are the leading cause of death in patients with chronic kidney disease (CKD). As matrix metalloproteinases have a major role in atherosclerosis, we investigated the relationship between MMP-10 and severity of atherosclerosis in patients with chronic kidney disease. This was evaluated in a cross-sectional, observational study of 30 patients with different stages of kidney disease, 30 patients on dialysis and 20 controls. The severity of atherosclerosis was estimated with carotid intima media thickness (CIMT) by carotid ultrasound. Serum levels of the matrix metalloproteinase-10 (MMP-10) was measured by ELISA and were significantly increased in patients with kidney disease compared with the healthy controls, and higher in patients on dialysis than in earlier stages of CKD. The severity of the atherosclerosis was also more prevalent in the dialysis group, in which serum levels of MMP-10 was significantly higher. Thus, patients with CKD exhibit elevated levels of circulating MMP-10, and this was independently associated with the severity of atherosclerosis and may represent a new biomarker of atherosclerotic diseases.