Introduction: Hypertension is an important cause of cardiovascular diseases with around 80–95% of hypertensive patients diagnosed as having “essential” hypertension. An increase in Intima-media thickness (IMT) has been used as a marker of the early atherosclerotic process.Material and Methods: A cross-sectional study was done at Department of Radiodiagnosis, SSIMS & RC, Davanagere, among 135 hypertensive patients above the age of 50 years, who were divided into two groups based on the grades of hypertension. Both grayscale (IMT and plaque assessment) and doppler (RI) parameters were assessed for bilateral CCA using high-frequency linear probe. All the patients’ blood pressure parameters and Fasting lipid profile parameters were taken. A correlation of the data was performed & results were obtained after statistical analysis.Results: Out of 135 cases with essential hypertension, 79 (58.5%) cases were Stage 1 hypertension [Subgroup I] and 56 (41.5%) cases were Stage 2 hypertension [Subgroup II] with almost equal distribution of both genders in each group.The IntimaMedia Thickness (IMT) were higher in Subgroup II compared to Subgroup I. The Mean values of subgroup I were 0.725±0.017 and 0.731±0.019 respectively and that of subgroup II were 0.741±0.013 on both sides with statistically significant results.The correlation between ultrasound, Doppler, blood pressure and biochemical parameters - Systolic blood pressure showed a positive correlation with both the grayscale parameter or Doppler parameter which was statistically significant.Conclusion: High frequency ultrasound with Color Doppler & biochemical parameters showed a significant correlation in the evaluation of Atherosclerosis involving carotid arteries.