Abstract: Objective To explore the possibility of glycaemia to predict atherosclerosis (AS). Methods In outpatient service the individuals who had cardiovascular disease(s) (CVDs) or previous mild hyperglycaemia were preferentially recruited to test 75 g oral glucose tolerance, blood lipid profile and blood pressure, and to document CVD history. They also received high resolution B-mode ultrasound evaluation for intima-media thickness (IMT), smoothness of intima and AS plaque. The AS score was calculated based on the ultrasound findings. The fasting and OGTT 2 h glycaemia were cut into quintiles, among which AS score and IMT were compared. The relationships of glycaemia with AS score, IMT, AS plaque, and abnormal IMT were explored by robust linear regression or logistic regression. Results With the fasting or 2 h glycaemia increasing the AS score and IMT increased gradually. The top quintile had considerably increased IMT and AS score. After being adjusted for age, sex, systolic and diastolic blood pressure, blood cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and medical history of hypertension, coronary heart disease and stroke, both fasting and OGTT 2 h glycaemia were independent predictors to AS score. The prediction of fasting glycaemia to IMT was independent of age, sex, lipid profile, blood pressure, and concurrent CVDs, while the prediction of OGTT 2 h glycaemia to IMT was independent of age, sex, and concurrent CVDs. And the prediction of both glycaemia to atherosclerotic plaque was independent of CVDs and their prediction to thickened IMT was independent of age, sex, and CVDs. Conclusion The fasting and OGTT 2 h glycaemia are independent predictors to atherosclerosis.