Background: Aortic valve sclerosis (AVS) is associated with an increase risk of cardiovascular events including stroke. The aim of the present study was to make a standardized method for qualitative and quantitative measurement of AVS and to assess the relationship between this method and the degree of carotid intima media thickness (IMT) in a neurologically asymptomatic general population. Method: We prospectively studied 117 patients (Male 43%, 57.9짹13.1 yrs) with peak aortic CW velocity <1.8m/sec, LVEF>55%, aand no rheumatic valvular disease. TTE and carotid duplex sonography were performed at the same time. The left- and non-coronary cusp were analyzed only. AVS was defined as increased thickness (>2 mm) in any part of two cusps during systole on the parasternal long axis view and valve motion was defined to be restricted if cusp showed inward flat or convex during systole on the parasternal short axis view. AVS severity were classified into two groups according to the degree of thickness and the presence of restricted motion of the cusp: AVS grade I: AVS of <3mm in one cusp without restricted motion;AVS grade II: AVS (+) in both cusps, AVS (+) and restricted motion in the same cusp, or thickness of >3mm. Both carotid artery was divided into 2 segments: the distal 1-cm section of the common carotid and carotid bulb. Far wall IMT was measured at the thickest part. The thickest and mean IMT of four segments were obtained. IMT >1.0mm in more than 2 segments were considered as a multiple increased IMT. Results: The thickest (p<0.001 for trend) and mean IMT (p=0.001 for trend) got thicker with an increasing severity of AVS. Multiple sites with increased IMT were more frequently observed in patients with more severe AVS (p<0.001 for trend). Conclusion: There is a significant association between AVS and carotid IMT both in the presence and the severity in a neurologically asymptomatic population.