Objective: To evaluate common carotid artery intima-media thickness (CCIMT) and cardiovascular risk factors in HIV-infected adolescents on combination antiretroviral therapy (cART). Methods: 23 HIV-infected adolescents were matched with 19 healthy subjects by gender, age and body mass index (BMI). CCIMT was measured by Echo-Doppler ultrasound. Bootstrapped multiple linear regression was used to identify potential predictors of CCIMT including HIV status, gender, age, BMI, waist circumference, HDL-cholesterol, LDL- cholesterol, triglycerides, folate, homocysteine and insulin resistance as detected by the homeostasis model assessment, mean blood pressure, and CD36 expression. Results: In the pooled sample, age ranged from 17 to 23 years and BMI between 16.0 and 25.6 kg/m2. Mean (SD) CCIMT was higher in HIV-infected than in healthy subjects [0.5 (0.1) vs 0.4 (0.1) mm, p < 0.001]. Higher values of CCIMT were associated with HIV infection (p < 0.001) and male gender (p < 0.001). CCIMT was also associated with the duration of treatment in subjects with the longest cART exposure, i.e. those exposed to a PI-based and/or NNRTI-based regimen plus a single or double NRTI (p = 0.019). Conclusion: HIV infection and longer duration of cART are associated with higher CCIMT in adolescents and young adults.