Background and Objectives : Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke, while carotid intima-media thickness (IMT) and plaque are also correlated with cardiovascular and cerebrovascular events. We evaluated the clinical, laboratory and echocardiographic risk factors for strokes in patients with AF. Methods: Seventy-nine patients (mean 67 years old, 53 men) with newly diagnosed or non-treated AF were enrolled. We evaluated the hematologic parameters (platelet count, fibrinogen, mean platelet component), lipid profiles, transthoracic echocardiography parmeters (thrombi, spontaneous echo contrast, left atrial size and volume), and both carotid artery IMT and presence of carotid plaque. Results: Eight strokes (10%) had occurred during mean-follow-up of 27.6 months,. There were no differences in age, sex, hematologic and echocardiographic parameters except presence of carotid plaque (8/8 vs. 38/71, p=0.012) between patients with and without strokes. Carotid plaque was found in 46 (58%) out of patients with AF, while all patients with strokes had carotid plaque. Patients with carotid plaque were associated with older age, increased LDL-cholesterol, increased carotid IMT. (Table) Conclusion: Carotid atheromatous plaque in patients with AF is a significant risk factor of strokes. Therefore, more intensive treatment is recommended in patients with carotid plaque and AF.