Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. It is associated with increased risk of cardiovascular disease (CVD). Carotid artery intima-media thickness (CIMT) is a non-invasive marker for early detection of CVD. The aim of this study was to evaluate CIMT as a predictor of CVD risk in patients with PCOS. Methods: This was a case-control study conducted on 100 women with PCOS and 100 healthy controls. Participants underwent assessment of CIMT, lipid profile, fasting blood glucose, insulin resistance, and other cardiovascular risk factors. Correlation analysis was performed between CIMT and various risk factors. Results: The mean CIMT was significantly higher in the PCOS group compared to the control group (p<0.001). The PCOS group also had lower levels of HDL cholesterol and higher levels of LDL cholesterol, homocysteine, and ferriman-gallwey score than the control group. CIMT was positively correlated with total cholesterol, HOMA-IR, and FGS, and negatively correlated with HDL cholesterol. However, no significant correlation was found between CIMT and age, BMI, fasting blood glucose, DHEAS, SHBG, total testosterone, triglycerides, HbA1c, homocysteine, FGS, blood pressure, waist-hip ratio, or FAI. Conclusion: This study suggests that CIMT can be used as a non-invasive predictor of CVD risk in patients with PCOS. Further studies with larger sample sizes are warranted to confirm these findings.