Background and objectives: Although most of the studies have indicated a negative correlation between bone mass density (BMD) and atherosclerosis in various sites of arterial system, some studies demonstrated no relation between these two conditions. This study was conducted to evaluate the possible relationship between bone mineral density (in femoral neck, hip and lumbar spine) and common carotid artery Intimal medial thickness in postmenopausal women. Methods and Patients: Iranian Postmenopausal women that at least 1 year had passed since the last menstrual period were included. The BMD was evaluated at the lumbar spine (in the L2-L4) femoral neck and hip by dual-energy X-ray absorptiometry (DXA). The carotid arteries IMT was assessed bilaterally using an ultrasonography in the 4 points at 2 cm proximal to the bulb, the 4 points at 2 cm distal to the bulb and 2 points at the carotid bulb and averaged to obtain the mean IMT. Results: Fifty eight subjects with the mean age of 58.76 +/- 5.51 years (range 50-74 years) were included in final analysis. Pearson correlation showed a significant negative correlation between MIT and BMD in femoral neck(r=0.717, P<0.001), hip(r=0.777, P<0.001), and spine(r=0.690, P<0.001). Similarly, spearman's correlation demonstrated a correlation between IMT and T scores in femoral neck(r=-0.340, P=0.009), hip(r=-0.533, P<0.001), andspine(r=-0.627, P<0.001). IMT of normal group was significantly higher than osteoporosis and osteopenia groups regarding to the T score of hip and spine. According to the t score of femoral neck IMT in osteoporosis group was significantly lower than osteopenia and normal BMD groups. Conclusion: The carotid atherosclerosis is negatively associated to BMD of spine, femoral neck and hip in postmenopausal women.