Cardiovascular disease is a main cause of morbidity and mortality among children and young adults after renal transplantation. The aim of study was to investigate the carotid intima media thickness (cIMT) and it's relation to risk factors for early arteriopathy in renal transplant patients. Twenty six renal transplant patients ( 14 girls, 12 boys) with stable graft function ( eGFR> 40 ml/1.73/m2 ) and 26 age and sex matched healthy controls were enrolled in this study. The measurement of cIMT was performed with high resolution B mode ultrasonography in multiple projections. The results were correlated with clinical and paraclinical parameters including : age, sex, BMI, blood pressure, GFR, duration of dialysis. Duration of CKD, CaxP product, cumulative dose of Ca based P binder and calcitriol, lipid profile, uric acid, cyclosporine level, and rejection episodes. The mean age of patients was 17 ±3.7 years. The mean time from CKD to transplantation was 33.5 ± 24.2 months. The average eGFR at the time of study was 87.3+ 34.8 ml/ min/ 1.73 m2 . Compared with control subjects, transplant patients had significantly higher cIMT. (P<0.001) . Among several risk factors, positive correlation was found between cIMT and age, duration of dialysis, and cumulative dose of calcitriol ( P< 0.02 , P < 0.04 , P< 0.02), respectively. In conlusion, subclinical atherosclerosis is present in young transplant recipients. Non invasive monitoring of cIMT in renal transplant patients for detection of early vascular lesions would be of outmost value in preventing cardiovascular disease.