Objective: The objective of the following study is to investigate the relationship between blood lipid levels and carotid intima-media thickness (CIMT) in Shanghai urban population. Materials and Methods: A total of 2504 residents over 40 years old in Jiading District of Shanghai municipality were divided into two groups in terms of the CIMT value 0.7 mm: Thickened group (n = 478) and normal group (n = 2026). All the patients received examinations of height, weight, waist, blood pressure, blood lipid level, hepatic and renal function, oral glucose tolerance test and carotid artery B-ultrasonography. Results: In comparison with those in CIMT normal group, the proportion of males, ages, body mass index, systolic blood pressure and levels of fast blood glucose, total cholesterol (TC), triglyceride (TG) and lowdensity lipoprotein cholesterol (LDL-C) were increased, but the levels of fast insulin were decreased (all P < 0.05). The risks of CIMT thickness were elevated by 19% and 25% as every increase in the standard deviation of the TC and LDL-C levels respectively (95% of confidence interval [CI] 1.08-1.31; 95% CI 1.13-1.37). Statistical analysis showed a significant correlation between CIMT thickness and TC/LDL-C. The levels of TG and high-density lipoprotein cholesterol were not associated with CIMT thickness. Conclusions: Levels of blood TC and LDL-C have significant correlations with the CIMT thickness in Shanghai urban population.