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Objective: Carotid intima-media thickness is a significant and independent predictor of coronary artery disease in patients with diabetes. The aim of our study was to determine carotid intima-media thickness in Nigerians with diabetes.Methods: This was an observational cross-sectional study involving consecutively presenting patients with type 2 diabetes mellitus and healthy age-matched adults. Anthropometric variables were measured, and blood samples collected for fasting blood sugar, cholesterol, and HbA1c. Carotid intima-media thickness was measured using a 2-D scanner. Association of carotid intima-media thickness with other variable was assessed using correlation and multivariable linear regression models.Results: One hundred and fifty two subjects (87 diabetics and 65 healthy adults) were studied. Carotid intimamedia thickness was significantly higher among diabetics. Seventy nine (90.8%) and seventy two (82.8%) patients with diabetes had carotid intima-media thickness greater than 0.9 mm and 1.0 mm respectively. Carotid intimamedia thickness was higher in patients with higher HbA1c, fasting blood sugar, body mass index, total cholesterol and LDL cholesterol, and significantly correlated with HbA1c, age, fasting blood sugar, systolic blood pressure, total cholesterol, LDL-c and HDL-c. Age, HbA1c and duration of hypertension predicted increased carotid intima-media thickness.Conclusion: The prevalence of increased carotid intima-media thickness is extremely high among Nigerians with diabetes, and this significantly correlated with other risk factors for cardiovascular diseases. Assessment of carotid intima-media thickness should be routinely included in evaluation of subjects with diabetes, and assessment of total cardiovascular risk.