Background: Cardiovascular complication caused by an accelerated atherosclerosis represent the largest single cause of mortality in chronic renal failure patients and a major cause of morbidity and mortality among patients with chronic renal insufficiency.High-resolution carotid ultrasonography is considered a fundamental technique for the investigation of the vascular system because of the extent of atherosclerosis in this vessel reflects the severity of arterial damage in other districts. Chronic inflammation as evidenced by increased levels of pro-inflammatory cytokines and CRP is common in chronic renal failure patients and may cause progressive atherosclerotic cardiovascular disease by several pathogenetic mechanisms. Objectives: Evaluation of the effect of chronic renal failure and regular hemodialysis on acceleration of atherosclerosis.Methods:Fifty patients of different age groups (30-60) and both genders will be subjected to full history ,complete clinical examination ,monthly follow up lab investigation for six subsequent months for CRP ,lipid profile, serum fibrinogen, ferritin, WBCs ,echocardiography and carotid duplex. Conclusion: present study show that increased incidence of carotid atherosclerosis in chronic renal failure patients more in the control group and was positively correlated with CRP levels and other risk factors for atherosclerosis.